Implementation Guide
ePA Medication Service
Version 1.0.5-1 - release

## Resource Profile: EPA MedicationRequest

Official URL: https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-request | Version: 1.0.5-1
Active as of 2025-02-28 | Computable Name: EPAMedicationRequest

Defines the medication request resource for the Medication Service in the ePA system.

Usage:

- Use this Resource Profile: EPA Operation ProvidePrescription ERP Input-Parameters
- Examples for this Resource Profile: MedicationRequest/3d7252b4-7814-4d40-8ca2-2f731648f22d and MedicationRequest/bb91cde8-0426-4f4b-a766-5d818d0605bd
- CapabilityStatements using this Resource Profile: EPA CapabilityStatement für den the Medication Service

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated 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 dom-6: A resource should have narrative for robust management dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
meta | S Σ | 0..1 | Meta | Metadata about the resource ele-1: All FHIR elements must have a @value or children
versionId | S Σ | 0..1 | id | Version specific identifier ele-1: All FHIR elements must have a @value or children
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed ele-1: All FHIR elements must have a @value or children
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:multiplePrescription | S | 0..1 | (Complex) | MultiplePrescription URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for extension |  |  |  | Content/Rules for all slices
extension:indicator |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] | S | 1..1 | boolean | Multiple Prescription Indicator ele-1: All FHIR elements must have a @value or children
extension:counter |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "counter"
value[x] | S | 1..1 | Ratio | Value of extension ele-1: All FHIR elements must have a @value or children
numerator | S Σ C | 1..1 | Quantity | Numerator value ele-1: All FHIR elements must have a @value or children qty-3: If a code for the unit is present, the system SHALL also be present
value | S Σ | 1..1 | decimal | Multiple Prescription Counter ele-1: All FHIR elements must have a @value or children
denominator | S Σ C | 1..1 | Quantity | Denominator value ele-1: All FHIR elements must have a @value or children qty-3: If a code for the unit is present, the system SHALL also be present
value | S Σ | 1..1 | decimal | Denominator of Multiple Prescription Series ele-1: All FHIR elements must have a @value or children
extension:period |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "period"
value[x] | S C | 1..1 | Period | Value of extension ele-1: All FHIR elements must have a @value or children -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD
start | S Σ C | 1..1 | dateTime | Start Date of the Prescription Redemption Period ele-1: All FHIR elements must have a @value or children
end | S Σ C | 0..1 | dateTime | End Date of the Prescription Redemption Period ele-1: All FHIR elements must have a @value or children
extension:id |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "id"
value[x] | S | 1..1 | Identifier | Value of extension ele-1: All FHIR elements must have a @value or children
system | S Σ | 0..1 | uri | Specification as UUID ele-1: All FHIR elements must have a @value or children Fixed Value: urn:ietf:rfc:3986
value | S Σ | 0..1 | string | Multiple Prescription ID ele-1: All FHIR elements must have a @value or children Example General: 123456
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
extension:isBvg | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension"
value[x] | S | 1..1 | boolean | BVG ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!N | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by pattern:$this ele-1: All FHIR elements must have a @value or children
identifier:RxPrescriptionProcessIdentifier |  | 0..1 | RxPrescriptionProcessIdentifier | External ids for this request ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
identifier:RxOriginatorProcessIdentifier |  | 0..1 | RxOriginatorProcessIdentifier | External ids for this request ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
status | ?!Σ | 1..1 | code | Status of Medication Request Binding: TI Medication Request ValueSet (required) ele-1: All FHIR elements must have a @value or children
intent | ?!S Σ | 1..1 | code | filler-order Binding: medicationRequest Intent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action ele-1: All FHIR elements must have a @value or children
medication[x] | S Σ | 1..1 | Reference(Medication) | Medication to be taken ele-1: All FHIR elements must have a @value or children
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for ele-1: All FHIR elements must have a @value or children ref-1: SHALL have a contained resource if a local reference is provided
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
identifier | S Σ | 1..1 | IdentifierKvid10 | Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children
authoredOn | S Σ | 1..1 | dateTime | Issue Date ele-1: All FHIR elements must have a @value or children
requester | S Σ C | 0..1 | Reference(Organization | Practitioner | PractitionerRole) | Who/What requested the Request ele-1: All FHIR elements must have a @value or children ref-1: SHALL have a contained resource if a local reference is provided
note | S | 0..1 | Annotation | Information about the prescription ele-1: All FHIR elements must have a @value or children
text | S Σ | 1..1 | markdown | Dispensing Note ele-1: All FHIR elements must have a @value or children
dosageInstruction | S | 0..1 | Dosage | Hier werden Informationen zur Dosierung angegeben. ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text | S Σ | 0..1 | string | Hier kann die Dosieranweisung in Form eines Freitextes abgebildet werden. ele-1: All FHIR elements must have a @value or children
patientInstruction | S Σ | 0..1 | string | Instructions for Use ele-1: All FHIR elements must have a @value or children
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
quantity | S C | 1..1 | SimpleQuantity | Amount of medication to supply per dispense ele-1: All FHIR elements must have a @value or children qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
value | S Σ | 1..1 | decimal | Number of Prescribed Packages ele-1: All FHIR elements must have a @value or children
system | S Σ C | 1..1 | uri | System that defines coded unit form ele-1: All FHIR elements must have a @value or children Required Pattern: http://unitsofmeasure.org
code | S Σ | 1..1 | code | Coded form of the unit ele-1: All FHIR elements must have a @value or children Required Pattern: {Package}
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
allowed[x] | S | 1..1 | boolean | Whether substitution is allowed or not ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | TIMedicationRequestStatusVS `https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs`
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
-limitationDateEnd | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : end.exists().not() or end.toString().length()=10 |
-limitationDateStart | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : start.toString().length()=10 |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** elements | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
qty-3 | error | MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator, MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator, MedicationRequest.dispenseRequest.quantity | If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists() |
ref-1 | error | MedicationRequest.subject, MedicationRequest.requester | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
sqty-1 | error | MedicationRequest.dispenseRequest.quantity | The comparator is not used on a SimpleQuantity : comparator.empty() |

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
meta | S | 0..1 | Meta | Metadata about the resource
versionId | S | 0..1 | id | Version specific identifier
lastUpdated | S | 0..1 | instant | When the resource version last changed
Slices for extension |  |  |  | Content/Rules for all slices
extension:multiplePrescription | S | 0..1 | (Complex) | MultiplePrescription URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:indicator |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | Ratio | Value of extension
numerator | S | 1..1 | Quantity | Numerator value
value | S | 1..1 | decimal | Multiple Prescription Counter
denominator | S | 1..1 | Quantity | Denominator value
value | S | 1..1 | decimal | Denominator of Multiple Prescription Series
extension:period |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | Period | Value of extension
start | S | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end | S | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | Identifier | Value of extension
system | S | 0..1 | uri | Specification as UUID
value | S | 0..1 | string | Multiple Prescription ID
extension:isBvg | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension
value[x] | S | 1..1 | boolean | BVG
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by pattern:$this
identifier:RxPrescriptionProcessIdentifier |  | 0..1 | RxPrescriptionProcessIdentifier | External ids for this request Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
identifier:RxOriginatorProcessIdentifier |  | 0..1 | RxOriginatorProcessIdentifier | External ids for this request Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
status |  | 1..1 | code | Status of Medication Request Binding: TI Medication Request ValueSet (required)
intent | S | 1..1 | code | filler-order
medication[x] | S | 1..1 | Reference(Medication) | Medication to be taken
subject | S | 1..1 | Reference(Patient) | Who or group medication request is for
identifier | S | 1..1 | IdentifierKvid10 | Logical reference, when literal reference is not known
authoredOn | S | 1..1 | dateTime | Issue Date
requester | S | 0..1 | Reference(Organization | Practitioner | PractitionerRole) | Who/What requested the Request
note | S | 0..1 | Annotation | Information about the prescription
text | S | 1..1 | markdown | Dispensing Note
dosageInstruction | S | 0..1 | Dosage | Hier werden Informationen zur Dosierung angegeben.
text | S | 0..1 | string | Hier kann die Dosieranweisung in Form eines Freitextes abgebildet werden.
patientInstruction | S | 0..1 | string | Instructions for Use
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
quantity | S | 1..1 | SimpleQuantity | Amount of medication to supply per dispense
value | S | 1..1 | decimal | Number of Prescribed Packages
system | S | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code | S | 1..1 | code | Coded form of the unit Required Pattern: {Package}
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
allowed[x] | S | 1..1 | boolean | Whether substitution is allowed or not
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | TIMedicationRequestStatusVS `https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs`

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:multiplePrescription | S | 0..1 | (Complex) | MultiplePrescription URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Closed by value:url
extension:indicator |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] | S | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "counter"
value[x] | S | 1..1 | Ratio | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
numerator | S Σ C | 1..1 | Quantity | Numerator value qty-3: If a code for the unit is present, the system SHALL also be present
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Multiple Prescription Counter
denominator | S Σ C | 1..1 | Quantity | Denominator value qty-3: If a code for the unit is present, the system SHALL also be present
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Denominator of Multiple Prescription Series
extension:period |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "period"
value[x] | S C | 1..1 | Period | Value of extension -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end | S Σ C | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "id"
value[x] | S | 1..1 | Identifier | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | Specification as UUID Fixed Value: urn:ietf:rfc:3986
value | S Σ | 0..1 | string | Multiple Prescription ID Example General: 123456
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
extension:isBvg | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension"
value[x] | S | 1..1 | boolean | BVG
modifierExtension | ?!N | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by pattern:$this
identifier:RxPrescriptionProcessIdentifier |  | 0..1 | RxPrescriptionProcessIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:RxOriginatorProcessIdentifier |  | 0..1 | RxOriginatorProcessIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!Σ | 1..1 | code | Status of Medication Request Binding: TI Medication Request ValueSet (required)
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!S Σ | 1..1 | code | filler-order Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | S Σ | 1..1 | Reference(Medication) | Medication to be taken
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for ref-1: SHALL have a contained resource if a local reference is provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | S Σ | 1..1 | IdentifierKvid10 | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter | C | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay ref-1: SHALL have a contained resource if a local reference is provided
supportingInformation | C | 0..* | Reference(Resource) | Information to support ordering of the medication ref-1: SHALL have a contained resource if a local reference is provided
authoredOn | S Σ | 1..1 | dateTime | Issue Date
requester | S Σ C | 0..1 | Reference(Organization | Practitioner | PractitionerRole) | Who/What requested the Request ref-1: SHALL have a contained resource if a local reference is provided
performer | C | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration ref-1: SHALL have a contained resource if a local reference is provided
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder | C | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request ref-1: SHALL have a contained resource if a local reference is provided
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference | C | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written ref-1: SHALL have a contained resource if a local reference is provided
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ C | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills ref-1: SHALL have a contained resource if a local reference is provided
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance | C | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage ref-1: SHALL have a contained resource if a local reference is provided
note | S | 0..1 | Annotation | Information about the prescription
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | Dispensing Note
dosageInstruction | S | 0..1 | Dosage | Hier werden Informationen zur Dosierung angegeben.
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Hier kann die Dosieranweisung in Form eines Freitextes abgebildet werden.
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | S Σ | 0..1 | string | Instructions for Use
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ C | 0..1 | Ratio | Upper limit on medication per unit of time rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
maxDosePerAdministration | Σ C | 0..1 | SimpleQuantity | Upper limit on medication per administration qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
maxDosePerLifetime | Σ C | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | C | 0..1 | SimpleQuantity | First fill quantity qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
duration | C | 0..1 | Duration | First fill duration Binding: CommonUCUMCodesForDuration (extensible): Appropriate units for Duration.
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
qty-3: If a code for the unit is present, the system SHALL also be present drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
dispenseInterval | C | 0..1 | Duration | Minimum period of time between dispenses Binding: CommonUCUMCodesForDuration (extensible): Appropriate units for Duration.
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
qty-3: If a code for the unit is present, the system SHALL also be present drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
validityPeriod | C | 0..1 | Period | Time period supply is authorized for per-1: If present, start SHALL have a lower value than end
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity | S C | 1..1 | SimpleQuantity | Amount of medication to supply per dispense qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Number of Prescribed Packages
unit | Σ | 0..1 | string | Unit representation
system | S Σ C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code | S Σ | 1..1 | code | Coded form of the unit Required Pattern: {Package}
expectedSupplyDuration | C | 0..1 | Duration | Number of days supply per dispense Binding: CommonUCUMCodesForDuration (extensible): Appropriate units for Duration.
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
qty-3: If a code for the unit is present, the system SHALL also be present drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
performer | C | 0..1 | Reference(Organization) | Intended dispenser ref-1: SHALL have a contained resource if a local reference is provided
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] | S | 1..1 | boolean | Whether substitution is allowed or not
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription | C | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced ref-1: SHALL have a contained resource if a local reference is provided
detectedIssue | C | 0..* | Reference(DetectedIssue) | Clinical Issue with action ref-1: SHALL have a contained resource if a local reference is provided
eventHistory | C | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle ref-1: SHALL have a contained resource if a local reference is provided
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels` from the FHIR Standard
MedicationRequest.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags` from the FHIR Standard
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | TIMedicationRequestStatusVS `https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs`
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` from the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` from the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` from the FHIR Standard
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` from the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` from the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` from the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.route | example | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` from the FHIR Standard
MedicationRequest.dispenseRequest.initialFill.duration | extensible | CommonUCUMCodesForDuration `http://hl7.org/fhir/ValueSet/duration-units` from the FHIR Standard
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
MedicationRequest.dispenseRequest.dispenseInterval | extensible | CommonUCUMCodesForDuration `http://hl7.org/fhir/ValueSet/duration-units` from the FHIR Standard
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
MedicationRequest.dispenseRequest.expectedSupplyDuration | extensible | CommonUCUMCodesForDuration `http://hl7.org/fhir/ValueSet/duration-units` from the FHIR Standard
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
-limitationDateEnd | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : end.exists().not() or end.toString().length()=10 |
-limitationDateStart | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : start.toString().length()=10 |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
drt-1 | error | MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.expectedSupplyDuration | There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. : code.exists() implies ((system = %ucum) and value.exists()) |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** elements | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
per-1 | error | MedicationRequest.dispenseRequest.validityPeriod | If present, start SHALL have a lower value than end : start.hasValue().not() or end.hasValue().not() or (start <= end) |
qty-3 | error | MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator, MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator, MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime, MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.quantity, MedicationRequest.dispenseRequest.expectedSupplyDuration | If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists() |
rat-1 | error | MedicationRequest.dosageInstruction.maxDosePerPeriod | Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()) |
ref-1 | error | MedicationRequest.subject, MedicationRequest.encounter, MedicationRequest.supportingInformation, MedicationRequest.requester, MedicationRequest.performer, MedicationRequest.recorder, MedicationRequest.reasonReference, MedicationRequest.basedOn, MedicationRequest.insurance, MedicationRequest.dispenseRequest.performer, MedicationRequest.priorPrescription, MedicationRequest.detectedIssue, MedicationRequest.eventHistory | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
sqty-1 | error | MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime, MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.quantity | The comparator is not used on a SimpleQuantity : comparator.empty() |

This structure is derived from MedicationRequest

Summary

Mandatory: 7 elements
Must-Support: 36 elements

Structures

This structure refers to these other structures:

- RxPrescriptionProcessIdentifier (https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier)
- RxOriginatorProcessIdentifier (https://gematik.de/fhir/epa-medication/StructureDefinition/rx-originator-process-identifier)
- Identifier-Profil für die 10-stellige Krankenversichertennummer (http://fhir.de/StructureDefinition/identifier-kvid-10)

Extensions

This structure refers to these extensions:

- https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.identifier

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated 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 dom-6: A resource should have narrative for robust management dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
meta | S Σ | 0..1 | Meta | Metadata about the resource ele-1: All FHIR elements must have a @value or children
versionId | S Σ | 0..1 | id | Version specific identifier ele-1: All FHIR elements must have a @value or children
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed ele-1: All FHIR elements must have a @value or children
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  |  |  | Content/Rules for all slices
extension:multiplePrescription | S | 0..1 | (Complex) | MultiplePrescription URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for extension |  |  |  | Content/Rules for all slices
extension:indicator |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] | S | 1..1 | boolean | Multiple Prescription Indicator ele-1: All FHIR elements must have a @value or children
extension:counter |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "counter"
value[x] | S | 1..1 | Ratio | Value of extension ele-1: All FHIR elements must have a @value or children
numerator | S Σ C | 1..1 | Quantity | Numerator value ele-1: All FHIR elements must have a @value or children qty-3: If a code for the unit is present, the system SHALL also be present
value | S Σ | 1..1 | decimal | Multiple Prescription Counter ele-1: All FHIR elements must have a @value or children
denominator | S Σ C | 1..1 | Quantity | Denominator value ele-1: All FHIR elements must have a @value or children qty-3: If a code for the unit is present, the system SHALL also be present
value | S Σ | 1..1 | decimal | Denominator of Multiple Prescription Series ele-1: All FHIR elements must have a @value or children
extension:period |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "period"
value[x] | S C | 1..1 | Period | Value of extension ele-1: All FHIR elements must have a @value or children -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD
start | S Σ C | 1..1 | dateTime | Start Date of the Prescription Redemption Period ele-1: All FHIR elements must have a @value or children
end | S Σ C | 0..1 | dateTime | End Date of the Prescription Redemption Period ele-1: All FHIR elements must have a @value or children
extension:id |  | 0..1 | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "id"
value[x] | S | 1..1 | Identifier | Value of extension ele-1: All FHIR elements must have a @value or children
system | S Σ | 0..1 | uri | Specification as UUID ele-1: All FHIR elements must have a @value or children Fixed Value: urn:ietf:rfc:3986
value | S Σ | 0..1 | string | Multiple Prescription ID ele-1: All FHIR elements must have a @value or children Example General: 123456
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
extension:isBvg | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension"
value[x] | S | 1..1 | boolean | BVG ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!N | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by pattern:$this ele-1: All FHIR elements must have a @value or children
identifier:RxPrescriptionProcessIdentifier |  | 0..1 | RxPrescriptionProcessIdentifier | External ids for this request ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
identifier:RxOriginatorProcessIdentifier |  | 0..1 | RxOriginatorProcessIdentifier | External ids for this request ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
status | ?!Σ | 1..1 | code | Status of Medication Request Binding: TI Medication Request ValueSet (required) ele-1: All FHIR elements must have a @value or children
intent | ?!S Σ | 1..1 | code | filler-order Binding: medicationRequest Intent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action ele-1: All FHIR elements must have a @value or children
medication[x] | S Σ | 1..1 | Reference(Medication) | Medication to be taken ele-1: All FHIR elements must have a @value or children
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for ele-1: All FHIR elements must have a @value or children ref-1: SHALL have a contained resource if a local reference is provided
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
identifier | S Σ | 1..1 | IdentifierKvid10 | Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children
authoredOn | S Σ | 1..1 | dateTime | Issue Date ele-1: All FHIR elements must have a @value or children
requester | S Σ C | 0..1 | Reference(Organization | Practitioner | PractitionerRole) | Who/What requested the Request ele-1: All FHIR elements must have a @value or children ref-1: SHALL have a contained resource if a local reference is provided
note | S | 0..1 | Annotation | Information about the prescription ele-1: All FHIR elements must have a @value or children
text | S Σ | 1..1 | markdown | Dispensing Note ele-1: All FHIR elements must have a @value or children
dosageInstruction | S | 0..1 | Dosage | Hier werden Informationen zur Dosierung angegeben. ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text | S Σ | 0..1 | string | Hier kann die Dosieranweisung in Form eines Freitextes abgebildet werden. ele-1: All FHIR elements must have a @value or children
patientInstruction | S Σ | 0..1 | string | Instructions for Use ele-1: All FHIR elements must have a @value or children
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
quantity | S C | 1..1 | SimpleQuantity | Amount of medication to supply per dispense ele-1: All FHIR elements must have a @value or children qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
value | S Σ | 1..1 | decimal | Number of Prescribed Packages ele-1: All FHIR elements must have a @value or children
system | S Σ C | 1..1 | uri | System that defines coded unit form ele-1: All FHIR elements must have a @value or children Required Pattern: http://unitsofmeasure.org
code | S Σ | 1..1 | code | Coded form of the unit ele-1: All FHIR elements must have a @value or children Required Pattern: {Package}
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution ele-1: All FHIR elements must have a @value or children
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
allowed[x] | S | 1..1 | boolean | Whether substitution is allowed or not ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | TIMedicationRequestStatusVS `https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs`
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
-limitationDateEnd | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : end.exists().not() or end.toString().length()=10 |
-limitationDateStart | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : start.toString().length()=10 |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** elements | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
qty-3 | error | MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator, MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator, MedicationRequest.dispenseRequest.quantity | If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists() |
ref-1 | error | MedicationRequest.subject, MedicationRequest.requester | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
sqty-1 | error | MedicationRequest.dispenseRequest.quantity | The comparator is not used on a SimpleQuantity : comparator.empty() |

Differential View

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
meta | S | 0..1 | Meta | Metadata about the resource
versionId | S | 0..1 | id | Version specific identifier
lastUpdated | S | 0..1 | instant | When the resource version last changed
Slices for extension |  |  |  | Content/Rules for all slices
extension:multiplePrescription | S | 0..1 | (Complex) | MultiplePrescription URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:indicator |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | Ratio | Value of extension
numerator | S | 1..1 | Quantity | Numerator value
value | S | 1..1 | decimal | Multiple Prescription Counter
denominator | S | 1..1 | Quantity | Denominator value
value | S | 1..1 | decimal | Denominator of Multiple Prescription Series
extension:period |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | Period | Value of extension
start | S | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end | S | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
value[x] | S | 1..1 | Identifier | Value of extension
system | S | 0..1 | uri | Specification as UUID
value | S | 0..1 | string | Multiple Prescription ID
extension:isBvg | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension
value[x] | S | 1..1 | boolean | BVG
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by pattern:$this
identifier:RxPrescriptionProcessIdentifier |  | 0..1 | RxPrescriptionProcessIdentifier | External ids for this request Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
identifier:RxOriginatorProcessIdentifier |  | 0..1 | RxOriginatorProcessIdentifier | External ids for this request Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
status |  | 1..1 | code | Status of Medication Request Binding: TI Medication Request ValueSet (required)
intent | S | 1..1 | code | filler-order
medication[x] | S | 1..1 | Reference(Medication) | Medication to be taken
subject | S | 1..1 | Reference(Patient) | Who or group medication request is for
identifier | S | 1..1 | IdentifierKvid10 | Logical reference, when literal reference is not known
authoredOn | S | 1..1 | dateTime | Issue Date
requester | S | 0..1 | Reference(Organization | Practitioner | PractitionerRole) | Who/What requested the Request
note | S | 0..1 | Annotation | Information about the prescription
text | S | 1..1 | markdown | Dispensing Note
dosageInstruction | S | 0..1 | Dosage | Hier werden Informationen zur Dosierung angegeben.
text | S | 0..1 | string | Hier kann die Dosieranweisung in Form eines Freitextes abgebildet werden.
patientInstruction | S | 0..1 | string | Instructions for Use
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
quantity | S | 1..1 | SimpleQuantity | Amount of medication to supply per dispense
value | S | 1..1 | decimal | Number of Prescribed Packages
system | S | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code | S | 1..1 | code | Coded form of the unit Required Pattern: {Package}
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
allowed[x] | S | 1..1 | boolean | Whether substitution is allowed or not
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | TIMedicationRequestStatusVS `https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:multiplePrescription | S | 0..1 | (Complex) | MultiplePrescription URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Closed by value:url
extension:indicator |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] | S | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "counter"
value[x] | S | 1..1 | Ratio | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
numerator | S Σ C | 1..1 | Quantity | Numerator value qty-3: If a code for the unit is present, the system SHALL also be present
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Multiple Prescription Counter
denominator | S Σ C | 1..1 | Quantity | Denominator value qty-3: If a code for the unit is present, the system SHALL also be present
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Denominator of Multiple Prescription Series
extension:period |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "period"
value[x] | S C | 1..1 | Period | Value of extension -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end | S Σ C | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "id"
value[x] | S | 1..1 | Identifier | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 0..1 | uri | Specification as UUID Fixed Value: urn:ietf:rfc:3986
value | S Σ | 0..1 | string | Multiple Prescription ID Example General: 123456
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
extension:isBvg | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension"
value[x] | S | 1..1 | boolean | BVG
modifierExtension | ?!N | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by pattern:$this
identifier:RxPrescriptionProcessIdentifier |  | 0..1 | RxPrescriptionProcessIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:RxOriginatorProcessIdentifier |  | 0..1 | RxOriginatorProcessIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!Σ | 1..1 | code | Status of Medication Request Binding: TI Medication Request ValueSet (required)
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!S Σ | 1..1 | code | filler-order Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | S Σ | 1..1 | Reference(Medication) | Medication to be taken
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for ref-1: SHALL have a contained resource if a local reference is provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | S Σ | 1..1 | IdentifierKvid10 | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter | C | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay ref-1: SHALL have a contained resource if a local reference is provided
supportingInformation | C | 0..* | Reference(Resource) | Information to support ordering of the medication ref-1: SHALL have a contained resource if a local reference is provided
authoredOn | S Σ | 1..1 | dateTime | Issue Date
requester | S Σ C | 0..1 | Reference(Organization | Practitioner | PractitionerRole) | Who/What requested the Request ref-1: SHALL have a contained resource if a local reference is provided
performer | C | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration ref-1: SHALL have a contained resource if a local reference is provided
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder | C | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request ref-1: SHALL have a contained resource if a local reference is provided
reasonCode |  | 0..* | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference | C | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written ref-1: SHALL have a contained resource if a local reference is provided
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ C | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills ref-1: SHALL have a contained resource if a local reference is provided
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance | C | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage ref-1: SHALL have a contained resource if a local reference is provided
note | S | 0..1 | Annotation | Information about the prescription
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | Dispensing Note
dosageInstruction | S | 0..1 | Dosage | Hier werden Informationen zur Dosierung angegeben.
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Hier kann die Dosieranweisung in Form eines Freitextes abgebildet werden.
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | S Σ | 0..1 | string | Instructions for Use
timing | Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | Σ | 0..1 |  | Amount of medication per dose
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ C | 0..1 | Ratio | Upper limit on medication per unit of time rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present
maxDosePerAdministration | Σ C | 0..1 | SimpleQuantity | Upper limit on medication per administration qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
maxDosePerLifetime | Σ C | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
dispenseRequest | S | 1..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | C | 0..1 | SimpleQuantity | First fill quantity qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
duration | C | 0..1 | Duration | First fill duration Binding: CommonUCUMCodesForDuration (extensible): Appropriate units for Duration.
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
qty-3: If a code for the unit is present, the system SHALL also be present drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
dispenseInterval | C | 0..1 | Duration | Minimum period of time between dispenses Binding: CommonUCUMCodesForDuration (extensible): Appropriate units for Duration.
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
qty-3: If a code for the unit is present, the system SHALL also be present drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
validityPeriod | C | 0..1 | Period | Time period supply is authorized for per-1: If present, start SHALL have a lower value than end
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity | S C | 1..1 | SimpleQuantity | Amount of medication to supply per dispense qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Number of Prescribed Packages
unit | Σ | 0..1 | string | Unit representation
system | S Σ C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code | S Σ | 1..1 | code | Coded form of the unit Required Pattern: {Package}
expectedSupplyDuration | C | 0..1 | Duration | Number of days supply per dispense Binding: CommonUCUMCodesForDuration (extensible): Appropriate units for Duration.
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
qty-3: If a code for the unit is present, the system SHALL also be present drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
performer | C | 0..1 | Reference(Organization) | Intended dispenser ref-1: SHALL have a contained resource if a local reference is provided
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension | N | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] | S | 1..1 | boolean | Whether substitution is allowed or not
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription | C | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced ref-1: SHALL have a contained resource if a local reference is provided
detectedIssue | C | 0..* | Reference(DetectedIssue) | Clinical Issue with action ref-1: SHALL have a contained resource if a local reference is provided
eventHistory | C | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle ref-1: SHALL have a contained resource if a local reference is provided
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationRequest.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels` from the FHIR Standard
MedicationRequest.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags` from the FHIR Standard
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.status | required | TIMedicationRequestStatusVS `https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs`
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` from the FHIR Standard
MedicationRequest.intent | required | medicationRequest Intent `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` from the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` from the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` from the FHIR Standard
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` from the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` from the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` from the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction | example | SNOMEDCTAdditionalDosageInstructions `http://hl7.org/fhir/ValueSet/additional-instruction-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x] | example | SNOMEDCTMedicationAsNeededReasonCodes `http://hl7.org/fhir/ValueSet/medication-as-needed-reason` from the FHIR Standard
MedicationRequest.dosageInstruction.site | example | SNOMEDCTAnatomicalStructureForAdministrationSiteCodes `http://hl7.org/fhir/ValueSet/approach-site-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.route | example | SNOMEDCTRouteCodes `http://hl7.org/fhir/ValueSet/route-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.method | example | SNOMEDCTAdministrationMethodCodes `http://hl7.org/fhir/ValueSet/administration-method-codes` from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type | example | DoseAndRateType `http://hl7.org/fhir/ValueSet/dose-rate-type` from the FHIR Standard
MedicationRequest.dispenseRequest.initialFill.duration | extensible | CommonUCUMCodesForDuration `http://hl7.org/fhir/ValueSet/duration-units` from the FHIR Standard
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
MedicationRequest.dispenseRequest.dispenseInterval | extensible | CommonUCUMCodesForDuration `http://hl7.org/fhir/ValueSet/duration-units` from the FHIR Standard
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
MedicationRequest.dispenseRequest.expectedSupplyDuration | extensible | CommonUCUMCodesForDuration `http://hl7.org/fhir/ValueSet/duration-units` from the FHIR Standard
Additional Bindings | Purpose
AllUCUMExpressionForTime | Max Binding
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
-limitationDateEnd | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : end.exists().not() or end.toString().length()=10 |
-limitationDateStart | error | MedicationRequest.extension:multiplePrescription.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD : start.toString().length()=10 |
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
drt-1 | error | MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.expectedSupplyDuration | There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. : code.exists() implies ((system = %ucum) and value.exists()) |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** elements | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
per-1 | error | MedicationRequest.dispenseRequest.validityPeriod | If present, start SHALL have a lower value than end : start.hasValue().not() or end.hasValue().not() or (start <= end) |
qty-3 | error | MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator, MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator, MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime, MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.quantity, MedicationRequest.dispenseRequest.expectedSupplyDuration | If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists() |
rat-1 | error | MedicationRequest.dosageInstruction.maxDosePerPeriod | Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present : (numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()) |
ref-1 | error | MedicationRequest.subject, MedicationRequest.encounter, MedicationRequest.supportingInformation, MedicationRequest.requester, MedicationRequest.performer, MedicationRequest.recorder, MedicationRequest.reasonReference, MedicationRequest.basedOn, MedicationRequest.insurance, MedicationRequest.dispenseRequest.performer, MedicationRequest.priorPrescription, MedicationRequest.detectedIssue, MedicationRequest.eventHistory | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
sqty-1 | error | MedicationRequest.dosageInstruction.maxDosePerAdministration, MedicationRequest.dosageInstruction.maxDosePerLifetime, MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.quantity | The comparator is not used on a SimpleQuantity : comparator.empty() |

This structure is derived from MedicationRequest

Summary

Mandatory: 7 elements
Must-Support: 36 elements

Structures

This structure refers to these other structures:

- RxPrescriptionProcessIdentifier (https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier)
- RxOriginatorProcessIdentifier (https://gematik.de/fhir/epa-medication/StructureDefinition/rx-originator-process-identifier)
- Identifier-Profil für die 10-stellige Krankenversichertennummer (http://fhir.de/StructureDefinition/identifier-kvid-10)

Extensions

This structure refers to these extensions:

- https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.identifier

Other representations of profile: CSV, Excel, Schematron