Medication
1.1.0 - STU Belgium flag

Medication, published by HL7 Belgium. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/medication/tree/prescription and changes regularly. See the Directory of published versions

Resource Profile: BeMedicationPrescription - Detailed Descriptions

Draft as of 2025-04-09

Definitions for the BeMedicationPrescription resource profile.

Guidance on how to interpret the contents of this table can be found here

0. MedicationRequest
Definition

An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

ShortOrdering of medication for patient or group
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesPrescription, Order
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dosage-override-reason-required: If isOffLabelUse is true, reason must be provided (extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/offLabel').hasValue() implies extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/offlabel').exists())
2. MedicationRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationRequest.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. MedicationRequest.extension:offLabel
    Slice NameoffLabel
    Definition

    Indicates that the order placer has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.

    ShortMedicationRequest - Off-label use
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(MedicationRequest - Off-label use) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    offLabel-reason-required: If isOffLabelUse is true, reason must be provided (extension.where(url = 'isOffLabelUse').value.ofType(boolean).where($this = true).exists() implies extension.where(url = 'reason').exists())
    8. MedicationRequest.extension:offLabel.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control10..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. MedicationRequest.extension:offLabel.extension:isOffLabelUse
      Slice NameisOffLabelUse
      Definition

      An Extension

      ShortIndicates that the recommended dosage was overriddenAdditional content defined by implementations
      Control10..1*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. MedicationRequest.extension:offLabel.extension:isOffLabelUse.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 14. MedicationRequest.extension:offLabel.extension:isOffLabelUse.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed ValueisOffLabelUse
        16. MedicationRequest.extension:offLabel.extension:reason
        Slice Namereason
        Definition

        An Extension

        ShortThe reason why the recommended dosage was overriddenAdditional content defined by implementations
        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. MedicationRequest.extension:offLabel.extension:reason.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 20. MedicationRequest.extension:offLabel.extension:reason.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuereason
          22. MedicationRequest.extension:offLabel.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttps://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/be-ext-OffLabel
          24. MedicationRequest.extension:offLabel.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control0..01
          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. MedicationRequest.extension:basedOnMedicationLine
          Slice NamebasedOnMedicationLine
          Definition

          Based on medication line.

          ShortMedication Line where this prescription is based upon
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(BasedOnMedicationLine) (Extension Type: Reference(BeMedicationLine))
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          28. MedicationRequest.extension:instructionsForReimbursement
          Slice NameinstructionsForReimbursement
          Definition

          Instructions for Reimbursement.

          ShortInstructions for reimbursement
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(InstructionsForReimbursement) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          30. MedicationRequest.extension:statusChanged
          Slice NamestatusChanged
          Definition

          Optional Extension Element - found in all resources.

          ShortIndicates when the status of the medication request was last changed.
          Comments

          This is a FHIR R5 element, preadopted as an extension in this FHIR R4 specification. For the full definition see here: http://hl7.org/fhir/R5/medicationrequest-definitions.html#MedicationRequest.statusChanged

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension Definition for MedicationRequest.statusChanged for Version 5.0) (Extension Type: dateTime)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          32. MedicationRequest.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          34. MedicationRequest.identifier
          Definition

          Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

          ShortExternal ids for this request
          Comments

          This is a business identifier, not a resource identifier.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ system
          • 36. MedicationRequest.identifier:recip-e
            Slice Namerecip-e
            Definition

            The national identifier for medication requests.


            Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

            ShortRecip-E identifierExternal ids for this request
            Comments

            This is a business identifier, not a resource identifier.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1*
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. MedicationRequest.identifier:recip-e.use
            Definition

            The purpose of this identifier.

            Shortusual | official | temp | secondary | old (If known)
            Comments

            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

            Control0..1
            BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

            Identifies the purpose for this identifier, if known .

            Typecode
            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. MedicationRequest.identifier:recip-e.system
            Definition

            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

            ShortThe namespace for the identifier value
            Comments

            Identifier.system is always case sensitive.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

            Pattern Valuehttp://ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-prescription
            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. MedicationRequest.identifier:recip-e.value
            Definition

            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

            ShortThe value that is unique
            Comments

            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Example<br/><b>General</b>:123456
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. MedicationRequest.status
            Definition

            A code specifying the current state of the order. Generally, this will be active or completed state.

            Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
            Comments

            This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

            Control1..1
            BindingThe codes SHALL be taken from medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
            (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

            A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

            Typecode
            Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. MedicationRequest.statusReason
            Definition

            Captures the reason for the current state of the MedicationRequest.

            ShortReason for current status
            Comments

            This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

            Control0..1
            BindingFor example codes, see medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reason
            (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

            Identifies the reasons for a given status.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. MedicationRequest.intent
            Definition

            Whether the request is a proposal, plan, or an original order.

            Shortproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
            Comments

            It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

            An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

            This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

            Control1..1
            BindingThe codes SHALL be taken from medicationRequest Intenthttp://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1
            (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

            The kind of medication order.

            Typecode
            Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. MedicationRequest.category
            Definition

            Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

            ShortType of medication usage
            Comments

            The category can be used to include where the medication is expected to be consumed or other types of requests.

            Control0..*
            BindingFor example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category
            (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

            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.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. MedicationRequest.priority
            Definition

            Indicates how quickly the Medication Request should be addressed with respect to other requests.

            Shortroutine | urgent | asap | stat
            Control0..1
            BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
            (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

            Identifies the level of importance to be assigned to actioning the request.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. MedicationRequest.doNotPerform
            Definition

            If true indicates that the provider is asking for the medication request not to occur.

            ShortTrue if request is prohibiting action
            Comments

            If do not perform is not specified, the request is a positive request e.g. "do perform".

            Control0..1
            Typeboolean
            Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. MedicationRequest.medication[x]
            Definition

            Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

            ShortMedication to be taken
            Comments

            If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

            Control1..1
            BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
            (example to http://hl7.org/fhir/ValueSet/medication-codes)

            A coded concept identifying substance or product that can be ordered.

            TypeChoice of: CodeableConcept, Reference(Medication)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. MedicationRequest.subject
            Definition

            A link to a resource representing the person or set of individuals to whom the medication will be given.

            ShortWho or group medication request is for
            Comments

            The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

            Control1..1
            TypeReference(BePatient, Patient, Group)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. MedicationRequest.supportingInformation
            Definition

            Include additional information (for example, patient height and weight) that supports the ordering of the medication.

            ShortInformation to support ordering of the medication
            Control0..*
            TypeReference(Resource)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. MedicationRequest.authoredOn
            Definition

            The date (and perhaps time) when the prescription was initially written or authored on.

            ShortWhen request was initially authored
            Control10..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. MedicationRequest.requester
            Definition

            The individual, organization, or device that initiated the request and has responsibility for its activation.

            ShortWho/What requested the Request
            Control10..1
            TypeReference(BePractitioner, BePractitionerRole, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. MedicationRequest.recorder
            Definition

            The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

            ShortPerson who entered the request
            Control0..1
            TypeReference(BePractitioner, BePractitionerRole, Practitioner, PractitionerRole)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. MedicationRequest.reasonCode
            Definition

            The reason or the indication for ordering or not ordering the medication.

            ShortReason or indication for ordering or not ordering the medication
            Comments

            This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

            Control0..*
            BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
            (example to http://hl7.org/fhir/ValueSet/condition-code)

            A coded concept indicating why the medication was ordered.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. MedicationRequest.reasonReference
            Definition

            Condition or observation that supports why the medication was ordered.

            ShortCondition or observation that supports why the prescription is being written
            Comments

            This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

            Control0..*
            TypeReference(Condition, Observation)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            72. MedicationRequest.groupIdentifier
            Definition

            A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

            ShortComposite request this is part of
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. MedicationRequest.note
            Definition

            Extra information about the prescription that could not be conveyed by the other attributes.

            ShortInformation about the prescription
            Control0..*
            TypeAnnotation
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. MedicationRequest.dosageInstruction
            Definition

            Indicates how the medication is to be used by the patient.

            ShortHow the medication should be taken
            Comments

            There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

            Control10..*
            TypeDosage
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. MedicationRequest.dispenseRequest
            Definition

            Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

            ShortMedication supply authorization
            Control0..1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. MedicationRequest.dispenseRequest.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            82. MedicationRequest.dispenseRequest.validityPeriod
            Definition

            This indicates the validity period of a prescription (stale dating the Prescription).

            ShortTime period supply is authorized for
            Comments

            The period of time that the prescription is valid for dispensing. The validity of the prescription for administration (i.e. whether the prescription can be administered after a given date) is conveyed in the dosage information.


            It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

            Control0..1
            TypePeriod
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. MedicationRequest.dispenseRequest.validityPeriod.start
            Definition

            The start of the period. The boundary is inclusive.

            ShortStarting time with inclusive boundary
            Comments

            If the low element is missing, the meaning is that the low boundary is not known.

            Control10..1
            This element is affected by the following invariants: per-1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. MedicationRequest.dispenseRequest.validityPeriod.end
            Definition

            The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

            ShortEnd time with inclusive boundary, if not ongoing
            Comments

            The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

            Control10..1
            This element is affected by the following invariants: per-1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
            Definition

            An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

            ShortNumber of refills authorized
            Comments

            If displaying "number of authorized fills", add 1 to this number.

            Control0..1
            TypeunsignedInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. MedicationRequest.dispenseRequest.quantity
            Definition

            The amount that is to be dispensed for one fill.

            ShortAmount of medication to supply per dispense
            Control0..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. MedicationRequest.substitution
            Definition

            Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

            ShortAny restrictions on medication substitution
            Control0..1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. MedicationRequest.substitution.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            96. MedicationRequest.substitution.allowed[x]
            Definition

            True if the prescriber allows a different drug to be dispensed from what was prescribed.

            ShortWhether substitution is allowed or not
            Comments

            This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

            Control1..1
            Typeboolean, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. MedicationRequest.substitution.reason
            Definition

            Indicates the reason for the substitution, or why substitution must or must not be performed.

            ShortWhy should (not) substitution be made
            Control0..1
            BindingFor example codes, see SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason
            (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

            A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

            Guidance on how to interpret the contents of this table can be found here

            0. MedicationRequest
            Invariantsdosage-override-reason-required: If isOffLabelUse is true, reason must be provided (extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/offLabel').hasValue() implies extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/offlabel').exists())
            2. MedicationRequest.extension
            SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 4. MedicationRequest.extension:offLabel
              Slice NameoffLabel
              Control0..1
              TypeExtension(MedicationRequest - Off-label use) (Complex Extension)
              Must Supporttrue
              6. MedicationRequest.extension:offLabel.extension:isOffLabelUse
              Slice NameisOffLabelUse
              ShortIndicates that the recommended dosage was overridden
              8. MedicationRequest.extension:offLabel.extension:reason
              Slice Namereason
              ShortThe reason why the recommended dosage was overridden
              10. MedicationRequest.extension:basedOnMedicationLine
              Slice NamebasedOnMedicationLine
              ShortMedication Line where this prescription is based upon
              Control0..1
              TypeExtension(BasedOnMedicationLine) (Extension Type: Reference(BeMedicationLine))
              Must Supporttrue
              12. MedicationRequest.extension:instructionsForReimbursement
              Slice NameinstructionsForReimbursement
              ShortInstructions for reimbursement
              Control0..1
              TypeExtension(InstructionsForReimbursement) (Extension Type: CodeableConcept)
              Must Supporttrue
              14. MedicationRequest.extension:statusChanged
              Slice NamestatusChanged
              ShortIndicates when the status of the medication request was last changed.
              Comments

              This is a FHIR R5 element, preadopted as an extension in this FHIR R4 specification. For the full definition see here: http://hl7.org/fhir/R5/medicationrequest-definitions.html#MedicationRequest.statusChanged

              Control0..1
              TypeExtension(Extension Definition for MedicationRequest.statusChanged for Version 5.0) (Extension Type: dateTime)
              16. MedicationRequest.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Must Supporttrue
              SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • pattern @ system
              • 18. MedicationRequest.identifier:recip-e
                Slice Namerecip-e
                Definition

                The national identifier for medication requests.

                ShortRecip-E identifier
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                Must Supporttrue
                20. MedicationRequest.identifier:recip-e.system
                Control1..?
                Pattern Valuehttp://ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-prescription
                22. MedicationRequest.identifier:recip-e.value
                Must Supporttrue
                24. MedicationRequest.status
                Must Supporttrue
                26. MedicationRequest.statusReason
                Must Supporttrue
                28. MedicationRequest.intent
                Must Supporttrue
                30. MedicationRequest.category
                Must Supporttrue
                32. MedicationRequest.priority
                Must Supporttrue
                34. MedicationRequest.medication[x]
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Must Supporttrue
                36. MedicationRequest.subject
                TypeReference(BePatient)
                Must Supporttrue
                38. MedicationRequest.supportingInformation
                Must Supporttrue
                40. MedicationRequest.authoredOn
                Control1..?
                Must Supporttrue
                42. MedicationRequest.requester
                Control1..?
                TypeReference(BePractitioner, BePractitionerRole)
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                44. MedicationRequest.recorder
                TypeReference(BePractitioner, BePractitionerRole)
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                46. MedicationRequest.reasonCode
                Must Supporttrue
                48. MedicationRequest.reasonReference
                Must Supporttrue
                50. MedicationRequest.groupIdentifier
                Must Supporttrue
                52. MedicationRequest.note
                Must Supporttrue
                54. MedicationRequest.dosageInstruction
                Control1..?
                Must Supporttrue
                56. MedicationRequest.dispenseRequest
                Must Supporttrue
                58. MedicationRequest.dispenseRequest.validityPeriod
                Comments

                The period of time that the prescription is valid for dispensing. The validity of the prescription for administration (i.e. whether the prescription can be administered after a given date) is conveyed in the dosage information.

                Must Supporttrue
                60. MedicationRequest.dispenseRequest.validityPeriod.start
                Control1..?
                Must Supporttrue
                62. MedicationRequest.dispenseRequest.validityPeriod.end
                Control1..?
                Must Supporttrue
                64. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                Must Supporttrue
                66. MedicationRequest.dispenseRequest.quantity
                Must Supporttrue
                68. MedicationRequest.substitution
                Must Supporttrue
                70. MedicationRequest.substitution.allowed[x]
                Typeboolean, CodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                72. MedicationRequest.substitution.reason
                Must Supporttrue

                Guidance on how to interpret the contents of this table can be found here

                0. MedicationRequest
                Definition

                An order or request for both supply of the medication and the instructions for administration of the medication to a patient. The resource is called "MedicationRequest" rather than "MedicationPrescription" or "MedicationOrder" to generalize the use across inpatient and outpatient settings, including care plans, etc., and to harmonize with workflow patterns.

                ShortOrdering of medication for patient or group
                Control0..*
                Is Modifierfalse
                Summaryfalse
                Alternate NamesPrescription, Order
                Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                dom-6: A resource should have narrative for robust management (text.`div`.exists())
                dosage-override-reason-required: If isOffLabelUse is true, reason must be provided (extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/offLabel').hasValue() implies extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/offlabel').exists())
                2. MedicationRequest.id
                Definition

                The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                ShortLogical id of this artifact
                Comments

                The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                Control0..1
                Typeid
                Is Modifierfalse
                Summarytrue
                4. MedicationRequest.meta
                Definition

                The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                ShortMetadata about the resource
                Control0..1
                TypeMeta
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                6. MedicationRequest.implicitRules
                Definition

                A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                ShortA set of rules under which this content was created
                Comments

                Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                Control0..1
                Typeuri
                Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                8. MedicationRequest.language
                Definition

                The base language in which the resource is written.

                ShortLanguage of the resource content
                Comments

                Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                Control0..1
                BindingThe codes SHOULD be taken from CommonLanguages
                (preferred to http://hl7.org/fhir/ValueSet/languages)

                A human language.

                Additional BindingsPurpose
                AllLanguagesMax Binding
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                10. MedicationRequest.text
                Definition

                A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                ShortText summary of the resource, for human interpretation
                Comments

                Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                Control0..1
                TypeNarrative
                Is Modifierfalse
                Summaryfalse
                Alternate Namesnarrative, html, xhtml, display
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                12. MedicationRequest.contained
                Definition

                These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                ShortContained, inline Resources
                Comments

                This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                Control0..*
                TypeResource
                Is Modifierfalse
                Summaryfalse
                Alternate Namesinline resources, anonymous resources, contained resources
                14. MedicationRequest.extension
                Definition

                An Extension

                ShortExtension
                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 16. MedicationRequest.extension:offLabel
                  Slice NameoffLabel
                  Definition

                  Indicates that the order placer has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.

                  ShortMedicationRequest - Off-label use
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(MedicationRequest - Off-label use) (Complex Extension)
                  Is Modifierfalse
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  offLabel-reason-required: If isOffLabelUse is true, reason must be provided (extension.where(url = 'isOffLabelUse').value.ofType(boolean).where($this = true).exists() implies extension.where(url = 'reason').exists())
                  18. MedicationRequest.extension:offLabel.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  20. MedicationRequest.extension:offLabel.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control1..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 22. MedicationRequest.extension:offLabel.extension:isOffLabelUse
                    Slice NameisOffLabelUse
                    Definition

                    An Extension

                    ShortIndicates that the recommended dosage was overridden
                    Control1..1
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    24. MedicationRequest.extension:offLabel.extension:isOffLabelUse.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    26. MedicationRequest.extension:offLabel.extension:isOffLabelUse.extension
                    Definition

                    An Extension

                    ShortExtension
                    Control0..0
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 28. MedicationRequest.extension:offLabel.extension:isOffLabelUse.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed ValueisOffLabelUse
                      30. MedicationRequest.extension:offLabel.extension:isOffLabelUse.value[x]
                      Definition

                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortValue of extension
                      Control0..1
                      Typeboolean
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      32. MedicationRequest.extension:offLabel.extension:reason
                      Slice Namereason
                      Definition

                      An Extension

                      ShortThe reason why the recommended dosage was overridden
                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      34. MedicationRequest.extension:offLabel.extension:reason.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      36. MedicationRequest.extension:offLabel.extension:reason.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..0
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 38. MedicationRequest.extension:offLabel.extension:reason.url
                        Definition

                        Source of the definition for the extension code - a logical name or a URL.

                        Shortidentifies the meaning of the extension
                        Comments

                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        Fixed Valuereason
                        40. MedicationRequest.extension:offLabel.extension:reason.value[x]
                        Definition

                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                        ShortValue of extension
                        Control0..1
                        TypeCodeableConcept
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        42. MedicationRequest.extension:offLabel.url
                        Definition

                        Source of the definition for the extension code - a logical name or a URL.

                        Shortidentifies the meaning of the extension
                        Comments

                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        Fixed Valuehttps://www.ehealth.fgov.be/standards/fhir/medication/StructureDefinition/be-ext-OffLabel
                        44. MedicationRequest.extension:offLabel.value[x]
                        Definition

                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                        ShortValue of extension
                        Control0..0
                        TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        46. MedicationRequest.extension:basedOnMedicationLine
                        Slice NamebasedOnMedicationLine
                        Definition

                        Based on medication line.

                        ShortMedication Line where this prescription is based upon
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(BasedOnMedicationLine) (Extension Type: Reference(BeMedicationLine))
                        Is Modifierfalse
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        48. MedicationRequest.extension:instructionsForReimbursement
                        Slice NameinstructionsForReimbursement
                        Definition

                        Instructions for Reimbursement.

                        ShortInstructions for reimbursement
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(InstructionsForReimbursement) (Extension Type: CodeableConcept)
                        Is Modifierfalse
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        50. MedicationRequest.extension:statusChanged
                        Slice NamestatusChanged
                        Definition

                        Optional Extension Element - found in all resources.

                        ShortIndicates when the status of the medication request was last changed.
                        Comments

                        This is a FHIR R5 element, preadopted as an extension in this FHIR R4 specification. For the full definition see here: http://hl7.org/fhir/R5/medicationrequest-definitions.html#MedicationRequest.statusChanged

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Extension Definition for MedicationRequest.statusChanged for Version 5.0) (Extension Type: dateTime)
                        Is Modifierfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        52. MedicationRequest.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Summaryfalse
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        54. MedicationRequest.identifier
                        Definition

                        Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                        ShortExternal ids for this request
                        Comments

                        This is a business identifier, not a resource identifier.

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..*
                        TypeIdentifier
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • pattern @ system
                        • 56. MedicationRequest.identifier:recip-e
                          Slice Namerecip-e
                          Definition

                          The national identifier for medication requests.

                          ShortRecip-E identifier
                          Comments

                          This is a business identifier, not a resource identifier.

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          58. MedicationRequest.identifier:recip-e.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          60. MedicationRequest.identifier:recip-e.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on MedicationRequest.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 62. MedicationRequest.identifier:recip-e.use
                            Definition

                            The purpose of this identifier.

                            Shortusual | official | temp | secondary | old (If known)
                            Comments

                            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                            Control0..1
                            BindingThe codes SHALL be taken from IdentifierUse
                            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                            Identifies the purpose for this identifier, if known .

                            Typecode
                            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            64. MedicationRequest.identifier:recip-e.type
                            Definition

                            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                            ShortDescription of identifier
                            Comments

                            This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                            (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                            A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Allows users to make use of identifiers when the identifier system is not known.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            66. MedicationRequest.identifier:recip-e.system
                            Definition

                            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                            ShortThe namespace for the identifier value
                            Comments

                            Identifier.system is always case sensitive.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                            Pattern Valuehttp://ehealth.fgov.be/standards/fhir/medication/NamingSystem/be-ns-prescription
                            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            68. MedicationRequest.identifier:recip-e.value
                            Definition

                            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                            ShortThe value that is unique
                            Comments

                            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Example<br/><b>General</b>:123456
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            70. MedicationRequest.identifier:recip-e.period
                            Definition

                            Time period during which identifier is/was valid for use.

                            ShortTime period when id is/was valid for use
                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            72. MedicationRequest.identifier:recip-e.assigner
                            Definition

                            Organization that issued/manages the identifier.

                            ShortOrganization that issued id (may be just text)
                            Comments

                            The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                            Control0..1
                            TypeReference(Organization)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            74. MedicationRequest.status
                            Definition

                            A code specifying the current state of the order. Generally, this will be active or completed state.

                            Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
                            Comments

                            This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                            Control1..1
                            BindingThe codes SHALL be taken from medicationrequest Status
                            (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

                            A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.

                            Typecode
                            Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            76. MedicationRequest.statusReason
                            Definition

                            Captures the reason for the current state of the MedicationRequest.

                            ShortReason for current status
                            Comments

                            This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the MedicationRequest was created at all is captured in reasonCode, not here.

                            Control0..1
                            BindingFor example codes, see medicationRequest Status Reason Codes
                            (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

                            Identifies the reasons for a given status.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            78. MedicationRequest.intent
                            Definition

                            Whether the request is a proposal, plan, or an original order.

                            Shortproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
                            Comments

                            It is expected that the type of requester will be restricted for different stages of a MedicationRequest. For example, Proposals can be created by a patient, relatedPerson, Practitioner or Device. Plans can be created by Practitioners, Patients, RelatedPersons and Devices. Original orders can be created by a Practitioner only.

                            An instance-order is an instantiation of a request or order and may be used to populate Medication Administration Record.

                            This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                            Control1..1
                            BindingThe codes SHALL be taken from medicationRequest Intent
                            (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

                            The kind of medication order.

                            Typecode
                            Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            80. MedicationRequest.category
                            Definition

                            Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

                            ShortType of medication usage
                            Comments

                            The category can be used to include where the medication is expected to be consumed or other types of requests.

                            Control0..*
                            BindingFor example codes, see medicationRequest Category Codes
                            (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

                            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.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            82. MedicationRequest.priority
                            Definition

                            Indicates how quickly the Medication Request should be addressed with respect to other requests.

                            Shortroutine | urgent | asap | stat
                            Control0..1
                            BindingThe codes SHALL be taken from RequestPriority
                            (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

                            Identifies the level of importance to be assigned to actioning the request.

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            84. MedicationRequest.doNotPerform
                            Definition

                            If true indicates that the provider is asking for the medication request not to occur.

                            ShortTrue if request is prohibiting action
                            Comments

                            If do not perform is not specified, the request is a positive request e.g. "do perform".

                            Control0..1
                            Typeboolean
                            Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            86. MedicationRequest.reported[x]
                            Definition

                            Indicates if this record was captured as a secondary 'reported' record rather than as an original primary source-of-truth record. It may also indicate the source of the report.

                            ShortReported rather than primary record
                            Control0..1
                            TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            88. MedicationRequest.medication[x]
                            Definition

                            Identifies the medication being requested. This is a link to a resource that represents the medication which may be the details of the medication or simply an attribute carrying a code that identifies the medication from a known list of medications.

                            ShortMedication to be taken
                            Comments

                            If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the Medication resource is recommended. For example, if you require form or lot number or if the medication is compounded or extemporaneously prepared, then you must reference the Medication resource.

                            Control1..1
                            BindingFor example codes, see SNOMEDCTMedicationCodes
                            (example to http://hl7.org/fhir/ValueSet/medication-codes)

                            A coded concept identifying substance or product that can be ordered.

                            TypeChoice of: CodeableConcept, Reference(Medication)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            90. MedicationRequest.subject
                            Definition

                            A link to a resource representing the person or set of individuals to whom the medication will be given.

                            ShortWho or group medication request is for
                            Comments

                            The subject on a medication request is mandatory. For the secondary use case where the actual subject is not provided, there still must be an anonymized subject specified.

                            Control1..1
                            TypeReference(BePatient)
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            92. MedicationRequest.encounter
                            Definition

                            The Encounter during which this [x] was created or to which the creation of this record is tightly associated.

                            ShortEncounter created as part of encounter/admission/stay
                            Comments

                            This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter." If there is a need to link to episodes of care they will be handled with an extension.

                            Control0..1
                            TypeReference(Encounter)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            94. MedicationRequest.supportingInformation
                            Definition

                            Include additional information (for example, patient height and weight) that supports the ordering of the medication.

                            ShortInformation to support ordering of the medication
                            Control0..*
                            TypeReference(Resource)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            96. MedicationRequest.authoredOn
                            Definition

                            The date (and perhaps time) when the prescription was initially written or authored on.

                            ShortWhen request was initially authored
                            Control1..1
                            TypedateTime
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            98. MedicationRequest.requester
                            Definition

                            The individual, organization, or device that initiated the request and has responsibility for its activation.

                            ShortWho/What requested the Request
                            Control1..1
                            TypeReference(BePractitioner, BePractitionerRole)
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            100. MedicationRequest.performer
                            Definition

                            The specified desired performer of the medication treatment (e.g. the performer of the medication administration).

                            ShortIntended performer of administration
                            Control0..1
                            TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            102. MedicationRequest.performerType
                            Definition

                            Indicates the type of performer of the administration of the medication.

                            ShortDesired kind of performer of the medication administration
                            Comments

                            If specified without indicating a performer, this indicates that the performer must be of the specified type. If specified with a performer then it indicates the requirements of the performer if the designated performer is not available.

                            Control0..1
                            BindingFor example codes, see ProcedurePerformerRoleCodes
                            (example to http://hl7.org/fhir/ValueSet/performer-role)

                            Identifies the type of individual that is desired to administer the medication.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            104. MedicationRequest.recorder
                            Definition

                            The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order.

                            ShortPerson who entered the request
                            Control0..1
                            TypeReference(BePractitioner, BePractitionerRole)
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            106. MedicationRequest.reasonCode
                            Definition

                            The reason or the indication for ordering or not ordering the medication.

                            ShortReason or indication for ordering or not ordering the medication
                            Comments

                            This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonReference.

                            Control0..*
                            BindingFor example codes, see Condition/Problem/DiagnosisCodes
                            (example to http://hl7.org/fhir/ValueSet/condition-code)

                            A coded concept indicating why the medication was ordered.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            108. MedicationRequest.reasonReference
                            Definition

                            Condition or observation that supports why the medication was ordered.

                            ShortCondition or observation that supports why the prescription is being written
                            Comments

                            This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

                            Control0..*
                            TypeReference(Condition, Observation)
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            110. MedicationRequest.instantiatesCanonical
                            Definition

                            The URL pointing to a protocol, guideline, orderset, or other definition that is adhered to in whole or in part by this MedicationRequest.

                            ShortInstantiates FHIR protocol or definition
                            Control0..*
                            Typecanonical
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            112. MedicationRequest.instantiatesUri
                            Definition

                            The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this MedicationRequest.

                            ShortInstantiates external protocol or definition
                            Control0..*
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            114. MedicationRequest.basedOn
                            Definition

                            A plan or request that is fulfilled in whole or in part by this medication request.

                            ShortWhat request fulfills
                            Control0..*
                            TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            116. MedicationRequest.groupIdentifier
                            Definition

                            A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription.

                            ShortComposite request this is part of
                            Control0..1
                            TypeIdentifier
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            118. MedicationRequest.courseOfTherapyType
                            Definition

                            The description of the overall patte3rn of the administration of the medication to the patient.

                            ShortOverall pattern of medication administration
                            Comments

                            This attribute should not be confused with the protocol of the medication.

                            Control0..1
                            BindingFor example codes, see medicationRequest Course of Therapy Codes
                            (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

                            Identifies the overall pattern of medication administratio.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. MedicationRequest.insurance
                            Definition

                            Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

                            ShortAssociated insurance coverage
                            Control0..*
                            TypeReference(Coverage, ClaimResponse)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. MedicationRequest.note
                            Definition

                            Extra information about the prescription that could not be conveyed by the other attributes.

                            ShortInformation about the prescription
                            Control0..*
                            TypeAnnotation
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            124. MedicationRequest.dosageInstruction
                            Definition

                            Indicates how the medication is to be used by the patient.

                            ShortHow the medication should be taken
                            Comments

                            There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

                            Control1..*
                            TypeDosage
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. MedicationRequest.dispenseRequest
                            Definition

                            Indicates the specific details for the dispense or medication supply part of a medication request (also known as a Medication Prescription or Medication Order). Note that this information is not always sent with the order. There may be in some settings (e.g. hospitals) institutional or system support for completing the dispense details in the pharmacy department.

                            ShortMedication supply authorization
                            Control0..1
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. MedicationRequest.dispenseRequest.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            130. MedicationRequest.dispenseRequest.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            132. MedicationRequest.dispenseRequest.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            134. MedicationRequest.dispenseRequest.initialFill
                            Definition

                            Indicates the quantity or duration for the first dispense of the medication.

                            ShortFirst fill details
                            Comments

                            If populating this element, either the quantity or the duration must be included.

                            Control0..1
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            136. MedicationRequest.dispenseRequest.initialFill.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            138. MedicationRequest.dispenseRequest.initialFill.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            140. MedicationRequest.dispenseRequest.initialFill.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            142. MedicationRequest.dispenseRequest.initialFill.quantity
                            Definition

                            The amount or quantity to provide as part of the first dispense.

                            ShortFirst fill quantity
                            Control0..1
                            TypeQuantity(SimpleQuantity)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            144. MedicationRequest.dispenseRequest.initialFill.duration
                            Definition

                            The length of time that the first dispense is expected to last.

                            ShortFirst fill duration
                            Control0..1
                            TypeDuration
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            146. MedicationRequest.dispenseRequest.dispenseInterval
                            Definition

                            The minimum period of time that must occur between dispenses of the medication.

                            ShortMinimum period of time between dispenses
                            Control0..1
                            TypeDuration
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            148. MedicationRequest.dispenseRequest.validityPeriod
                            Definition

                            This indicates the validity period of a prescription (stale dating the Prescription).

                            ShortTime period supply is authorized for
                            Comments

                            The period of time that the prescription is valid for dispensing. The validity of the prescription for administration (i.e. whether the prescription can be administered after a given date) is conveyed in the dosage information.

                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Indicates when the Prescription becomes valid, and when it ceases to be a dispensable Prescription.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            150. MedicationRequest.dispenseRequest.validityPeriod.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            152. MedicationRequest.dispenseRequest.validityPeriod.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.validityPeriod.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 154. MedicationRequest.dispenseRequest.validityPeriod.start
                              Definition

                              The start of the period. The boundary is inclusive.

                              ShortStarting time with inclusive boundary
                              Comments

                              If the low element is missing, the meaning is that the low boundary is not known.

                              Control1..1
                              This element is affected by the following invariants: per-1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              156. MedicationRequest.dispenseRequest.validityPeriod.end
                              Definition

                              The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                              ShortEnd time with inclusive boundary, if not ongoing
                              Comments

                              The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                              Control1..1
                              This element is affected by the following invariants: per-1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              158. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                              Definition

                              An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

                              ShortNumber of refills authorized
                              Comments

                              If displaying "number of authorized fills", add 1 to this number.

                              Control0..1
                              TypeunsignedInt
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              160. MedicationRequest.dispenseRequest.quantity
                              Definition

                              The amount that is to be dispensed for one fill.

                              ShortAmount of medication to supply per dispense
                              Control0..1
                              TypeQuantity(SimpleQuantity)
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              162. MedicationRequest.dispenseRequest.expectedSupplyDuration
                              Definition

                              Identifies the period time over which the supplied product is expected to be used, or the length of time the dispense is expected to last.

                              ShortNumber of days supply per dispense
                              Comments

                              In some situations, this attribute may be used instead of quantity to identify the amount supplied by how long it is expected to last, rather than the physical quantity issued, e.g. 90 days supply of medication (based on an ordered dosage). When possible, it is always better to specify quantity, as this tends to be more precise. expectedSupplyDuration will always be an estimate that can be influenced by external factors.

                              Control0..1
                              TypeDuration
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              164. MedicationRequest.dispenseRequest.performer
                              Definition

                              Indicates the intended dispensing Organization specified by the prescriber.

                              ShortIntended dispenser
                              Control0..1
                              TypeReference(Organization)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              166. MedicationRequest.substitution
                              Definition

                              Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

                              ShortAny restrictions on medication substitution
                              Control0..1
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              168. MedicationRequest.substitution.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              170. MedicationRequest.substitution.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              172. MedicationRequest.substitution.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              174. MedicationRequest.substitution.allowed[x]
                              Definition

                              True if the prescriber allows a different drug to be dispensed from what was prescribed.

                              ShortWhether substitution is allowed or not
                              Comments

                              This element is labeled as a modifier because whether substitution is allow or not, it cannot be ignored.

                              Control1..1
                              Typeboolean
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              176. MedicationRequest.substitution.reason
                              Definition

                              Indicates the reason for the substitution, or why substitution must or must not be performed.

                              ShortWhy should (not) substitution be made
                              Control0..1
                              BindingFor example codes, see SubstanceAdminSubstitutionReason
                              (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                              A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              178. MedicationRequest.priorPrescription
                              Definition

                              A link to a resource representing an earlier order related order or prescription.

                              ShortAn order/prescription that is being replaced
                              Control0..1
                              TypeReference(MedicationRequest)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              180. MedicationRequest.detectedIssue
                              Definition

                              Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

                              ShortClinical Issue with action
                              Comments

                              This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                              Control0..*
                              TypeReference(DetectedIssue)
                              Is Modifierfalse
                              Summaryfalse
                              Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              182. MedicationRequest.eventHistory
                              Definition

                              Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

                              ShortA list of events of interest in the lifecycle
                              Comments

                              This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                              Control0..*
                              TypeReference(Provenance)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))