Implementation Guide
ePA Medication Service
Version 1.2.0 - release

Resource Profile: EMPMedicationRequest - Detailed Descriptions

Active as of 2025-09-12

Definitions for the emp-medication-request resource profile.

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

0. MedicationRequest
Definition

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

ShortOrdering of medication for patient or group
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesPrescription, Order
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. MedicationRequest.meta
Definition

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

ShortMetadata about the resource
Control0..1
This element is affected by the following invariants: ele-1
TypeMeta
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationRequest.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

ShortVersion specific identifier
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

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

When the resource last changed - e.g. when the version changed.

ShortWhen the resource version last changed
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Control0..1
This element is affected by the following invariants: ele-1
Typeinstant
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationRequest.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

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

    Extension for indicating the context.

    ShortExtension
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(ContextExtension) (Extension Type: code)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. MedicationRequest.extension:context.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

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

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

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
      18. MedicationRequest.extension:context.value[x]
      Definition

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

      ShortContext of the resourceValue of extension
      Control10..1
      This element is affected by the following invariants: ele-1
      BindingThe codes SHALL be taken from For codes, see Context Codes
      (required to https://gematik.de/fhir/epa-medication/ValueSet/context-code)
      Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Pattern ValueEMP
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. MedicationRequest.extension:activity
      Slice Nameactivity
      Definition

      Bildet eine Aktivität in bezug auf ein EMPMedicationRequest ab

      ShortAktivität die zu diesem Planelement gehört
      Control0..*
      TypeExtension(EMPMedicationRequestActitvityExtension) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      22. MedicationRequest.extension:reasonPatientInstruction
      Slice NamereasonPatientInstruction
      Definition

      Benennt den Behandlungsanlass für das Arzneimittel in versichertenverständlicher Form und unterstützt so Verständnis und Wiedererkennung auf dem eMP. Ergänzend angegebene ICD-10-Codes enthalten oft vergleichbare Informationen in medizinischer Fachsprache.

      ShortPatientenlesbarer Grund für den Planungseintrag
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(ReasonPatientInstructionExtension) (Extension Type: string)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      24. MedicationRequest.extension:patientNote
      Slice NamepatientNote
      Definition

      Übergeordnete Hinweise zur Therapie mit dem zugeordneten Arzneimittel; sie richten sich an den Versicherten, sind aber nicht der Dosierung zuzuordnen. Hierzu gehören bspw. mögliche unerwünschte Arzneimittelwirkungen, Empfehlungen zu regelmäßigen Kontrolluntersuchungen oder zur korrekten Lagerung des Arzneimittels.

      ShortHinweis für den Patienten
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(PatientNoteExtension) (Extension Type: Annotation)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      26. MedicationRequest.extension:effectiveDosePeriod
      Slice NameeffectiveDosePeriod
      Definition

      Zeitraum, über den die Medikation eingenommen werden soll. Wenn mehrere dosageInstruction-Zeilen vorhanden sind (z. B. bei einer ausschleichenden Dosierung), entspricht dieser Zeitraum dem frühesten Startdatum und dem spätesten Enddatum der dosageInstructions.

      ShortZeitraum, in dem die Medikation eingenommen werden soll.
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension Definition for MedicationRequest.effectiveDosePeriod for Version 5.0) (Extension Type: Period)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      28. MedicationRequest.extension:effectiveDosePeriod.extension
      Definition

      An Extension


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

      ShortExtensionAdditional content defined by implementations
      Comments

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

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

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

        Shortidentifies the meaning of the extension
        Comments

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

        Control1..1
        Typeuri
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
        32. MedicationRequest.extension:effectiveDosePeriod.value[x]
        Definition

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

        ShortValue of extension
        Control10..1
        This element is affected by the following invariants: ele-1
        TypePeriod, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. MedicationRequest.extension:effectiveDosePeriod.value[x].start
        Definition

        The start of the period. The boundary is inclusive.

        ShortStarting time with inclusive boundary
        Comments

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

        Control0..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        epa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
        36. MedicationRequest.extension:effectiveDosePeriod.value[x].end
        Definition

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

        ShortEnd time with inclusive boundary, if not ongoing
        Comments

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

        Control0..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        epa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
        38. MedicationRequest.extension:renderedDosageInstruction
        Slice NamerenderedDosageInstruction
        Definition

        Ein menschenlesbarer, vollständiger Text der Dosierungsanweisungen. Der Text wird aus den strukturierten Dosage-Elementen generiert und dient der patientensicheren Darstellung der Dosierung. Er soll die maschinenlesbaren Angaben konsistent wiedergeben und in einer für Patient:innen verständlichen Form bereitstellen.

        ShortVollständige Darstellung der Dosierungsanweisungen (generiert aus den Dosage-Elementen).
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension Definition for MedicationRequest.renderedDosageInstruction for Version 5.0) (Extension Type: markdown)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        40. MedicationRequest.extension:generatedDosageInstructionsMeta
        Slice NamegeneratedDosageInstructionsMeta
        Definition

        Diese Extension enthält zusätzliche Metadaten zu den automatisch generierten Dosierungsanweisungen, wie z.B. Informationen zur Generierung oder zum Ursprung der Daten.

        ShortMetadaten zu den generierten Dosierungsanweisungen
        Control0..1
        TypeExtension(Generated Dosage Instructions Meta) (Complex Extension)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        42. MedicationRequest.extension:originMedication
        Slice NameoriginMedication
        Definition

        Zeigt auf die Medication-Instanz, die als Grundlage für diesen MedicationRequest diente und stellt so den Ursprung (Origin) des eMP-Eintrags dar.

        ShortReferenz auf die Ursprungs-Medication (Basis des eMP-Eintrags)
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Origin Medication Reference (eMP)) (Extension Type: Reference(Medication))
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        44. MedicationRequest.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored
        Comments

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

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

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

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

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

          ShortExternal ids for this request
          Comments

          This is a business identifier, not a resource identifier.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ $this
          • 48. MedicationRequest.identifier:MedicationPlanIdentifier
            Slice NameMedicationPlanIdentifier
            Definition

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

            ShortExternal ids for this request
            Comments

            This is a business identifier, not a resource identifier.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeIdentifier(Profil für den Identifikator eines eMP-Eintrags)
            Is Modifierfalse
            Must Supporttrue
            Pattern Value{
              "system" : "https://gematik.de/fhir/sid/emp-identifier"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. MedicationRequest.status
            Definition

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

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

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

            Control1..1
            BindingThe codes SHALL be taken from eMP MedicationRequest Status Value Sethttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
            (required to https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs)
            Typecode
            Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. MedicationRequest.intent
            Definition

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

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

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

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

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

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

            The kind of medication order.

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

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

            ShortTrue if request is prohibiting action
            Comments

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

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

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

            ShortArzneimittel, welches geplant wirdMedication to be taken
            Comments

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

            Control1..1
            This element is affected by the following invariants: ele-1
            TypeReference(EPA Medication, Medication), CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. MedicationRequest.subject
            Definition

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

            ShortWho or group medication request is for
            Comments

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

            Control1..1
            This element is affected by the following invariants: ele-1
            TypeReference(Patient, Patient, Group)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ref-1: 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')))
            60. MedicationRequest.subject.identifier
            Definition

            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

            ShortLogical reference, when literal reference is not known
            Comments

            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control10..1
            This element is affected by the following invariants: ele-1
            TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. MedicationRequest.authoredOn
            Definition

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

            ShortWhen request was initially authored
            Control10..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            epa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
            64. MedicationRequest.reasonCode
            Definition

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

            ShortReason or indication for ordering or not ordering the medication
            Comments

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

            Control0..1*
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
            (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

            A coded concept indicating why the medication was ordered.

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

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationRequest.reasonCode.coding. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • pattern @ $this
            • 68. MedicationRequest.reasonCode.coding:icd-10-gm
              Slice Nameicd-10-gm
              Definition

              Der ICD-Code ist in Deutschland das abrechnungsrelevante Code System im ambulanten und stationären Bereich.


              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..1*
              This element is affected by the following invariants: ele-1
              TypeCoding(Coding-Profil für ICD-10-GM)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Pattern Value{
                "system" : "http://fhir.de/CodeSystem/bfarm/icd-10-gm"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. MedicationRequest.reasonCode.coding:icd-10-gm.extension:Mehrfachcodierungs-Kennzeichen
              Slice NameMehrfachcodierungs-Kennzeichen
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Mehrfachkodierungs-Kennzeichen bei ICD-10-gm) (Extension Type: Coding)
              Is Modifierfalse
              Standard StatusNormative (from Trial Use)
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              72. MedicationRequest.reasonCode.coding:icd-10-gm.extension:Seitenlokalisation
              Slice NameSeitenlokalisation
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(ExtensionSeitenlokalisation) (Extension Type: Coding)
              Is Modifierfalse
              Standard StatusNormative (from Trial Use)
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              74. MedicationRequest.reasonCode.coding:icd-10-gm.extension:Diagnosesicherheit
              Slice NameDiagnosesicherheit
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Extension zur Erfassung der Diagnosesicherheit gemäß KBV-Kodierrichtlinien) (Extension Type: Coding)
              Is Modifierfalse
              Standard StatusNormative (from Trial Use)
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              76. MedicationRequest.reasonCode.coding:icd-10-gm.system
              Definition

              The identification of the code system that defines the meaning of the symbol in the code.

              ShortCanonische CodeSystem URL für ICD-10-GMIdentity of the terminology system
              Comments

              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

              Need to be unambiguous about the source of the definition of the symbol.

              Fixed Valuehttp://fhir.de/CodeSystem/bfarm/icd-10-gm
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. MedicationRequest.reasonCode.coding:icd-10-gm.version
              Definition

              Bie Verwendung von ICD-10-GM ist die Angabe der Version zwingend erforderlich. Hierdurch wird der Tatsache Rechnung getragen, dass jede der jährlich neu erscheinenden Fassung von ICD-10-GM ein neues Codesystem darstellt.


              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

              ShortDie Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")Version of the system - if relevant
              Comments

              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

              NoteThis is a business version Id, not a resource version Id (see discussion)
              Control10..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. MedicationRequest.reasonCode.coding:icd-10-gm.code
              Definition

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

              ShortDer ICD-10-CodeSymbol in syntax defined by the system
              Control10..1
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              ExampleEinfacher ICD-Code: F17.4
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              icd-regex: In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt (matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$'))
              82. MedicationRequest.reasonCode.coding:icd-10-gm.display
              Definition

              A representation of the meaning of the code in the system, following the rules of the system.

              ShortRepresentation defined by the system
              Comments

              Note that FHIR strings SHALL NOT exceed 1MB in size

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

              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

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

              ShortZusätzliche Informationen durch einen LeistungserbringendenInformation about the prescription
              Comments

              For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

              Control0..1*
              This element is affected by the following invariants: ele-1
              TypeAnnotation
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. MedicationRequest.note.time
              Definition

              Indicates when this particular annotation was made.

              ShortWhen the annotation was made
              Comments

              This information should be generated automatically

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

              The text of the annotation in markdown format.

              ShortThe annotation - text content (as markdown)
              Comments

              Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

              Control1..1
              Typemarkdown
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. MedicationRequest.dosageInstruction
              Definition

              Hier werden Informationen zur Dosierung angegeben.


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

              ShortHier werden Informationen zur Dosierung angegeben.How the medication should be taken
              Comments

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

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

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

              0. MedicationRequest
              2. MedicationRequest.meta
              Must Supporttrue
              4. MedicationRequest.meta.versionId
              Must Supporttrue
              6. MedicationRequest.meta.lastUpdated
              Must Supporttrue
              8. MedicationRequest.extension
              Control1..?
              10. MedicationRequest.extension:context
              Slice Namecontext
              Control1..1
              TypeExtension(ContextExtension) (Extension Type: code)
              Must Supporttrue
              12. MedicationRequest.extension:context.value[x]
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Pattern ValueEMP
              14. MedicationRequest.extension:activity
              Slice Nameactivity
              ShortAktivität die zu diesem Planelement gehört
              Control0..*
              TypeExtension(EMPMedicationRequestActitvityExtension) (Complex Extension)
              Must Supporttrue
              16. MedicationRequest.extension:reasonPatientInstruction
              Slice NamereasonPatientInstruction
              Definition

              Benennt den Behandlungsanlass für das Arzneimittel in versichertenverständlicher Form und unterstützt so Verständnis und Wiedererkennung auf dem eMP. Ergänzend angegebene ICD-10-Codes enthalten oft vergleichbare Informationen in medizinischer Fachsprache.

              ShortPatientenlesbarer Grund für den Planungseintrag
              Control0..1
              TypeExtension(ReasonPatientInstructionExtension) (Extension Type: string)
              Must Supporttrue
              18. MedicationRequest.extension:patientNote
              Slice NamepatientNote
              Definition

              Übergeordnete Hinweise zur Therapie mit dem zugeordneten Arzneimittel; sie richten sich an den Versicherten, sind aber nicht der Dosierung zuzuordnen. Hierzu gehören bspw. mögliche unerwünschte Arzneimittelwirkungen, Empfehlungen zu regelmäßigen Kontrolluntersuchungen oder zur korrekten Lagerung des Arzneimittels.

              ShortHinweis für den Patienten
              Control0..1
              TypeExtension(PatientNoteExtension) (Extension Type: Annotation)
              Must Supporttrue
              20. MedicationRequest.extension:effectiveDosePeriod
              Slice NameeffectiveDosePeriod
              Definition

              Zeitraum, über den die Medikation eingenommen werden soll. Wenn mehrere dosageInstruction-Zeilen vorhanden sind (z. B. bei einer ausschleichenden Dosierung), entspricht dieser Zeitraum dem frühesten Startdatum und dem spätesten Enddatum der dosageInstructions.

              ShortZeitraum, in dem die Medikation eingenommen werden soll.
              Control0..1
              TypeExtension(Extension Definition for MedicationRequest.effectiveDosePeriod for Version 5.0) (Extension Type: Period)
              Must Supporttrue
              22. MedicationRequest.extension:effectiveDosePeriod.value[x]
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              24. MedicationRequest.extension:effectiveDosePeriod.value[x].start
              Invariantsepa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
              26. MedicationRequest.extension:effectiveDosePeriod.value[x].end
              Invariantsepa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
              28. MedicationRequest.extension:renderedDosageInstruction
              Slice NamerenderedDosageInstruction
              Definition

              Ein menschenlesbarer, vollständiger Text der Dosierungsanweisungen. Der Text wird aus den strukturierten Dosage-Elementen generiert und dient der patientensicheren Darstellung der Dosierung. Er soll die maschinenlesbaren Angaben konsistent wiedergeben und in einer für Patient:innen verständlichen Form bereitstellen.

              ShortVollständige Darstellung der Dosierungsanweisungen (generiert aus den Dosage-Elementen).
              Control0..1
              TypeExtension(Extension Definition for MedicationRequest.renderedDosageInstruction for Version 5.0) (Extension Type: markdown)
              Must Supporttrue
              30. MedicationRequest.extension:generatedDosageInstructionsMeta
              Slice NamegeneratedDosageInstructionsMeta
              Definition

              Diese Extension enthält zusätzliche Metadaten zu den automatisch generierten Dosierungsanweisungen, wie z.B. Informationen zur Generierung oder zum Ursprung der Daten.

              ShortMetadaten zu den generierten Dosierungsanweisungen
              Control0..1
              TypeExtension(Generated Dosage Instructions Meta) (Complex Extension)
              Must Supporttrue
              32. MedicationRequest.extension:originMedication
              Slice NameoriginMedication
              Definition

              Zeigt auf die Medication-Instanz, die als Grundlage für diesen MedicationRequest diente und stellt so den Ursprung (Origin) des eMP-Eintrags dar.

              ShortReferenz auf die Ursprungs-Medication (Basis des eMP-Eintrags)
              Control0..1
              TypeExtension(Origin Medication Reference (eMP)) (Extension Type: Reference(Medication))
              Must Supporttrue
              34. MedicationRequest.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ $this
              • 36. MedicationRequest.identifier:MedicationPlanIdentifier
                Slice NameMedicationPlanIdentifier
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier(Profil für den Identifikator eines eMP-Eintrags)
                Must Supporttrue
                Pattern Value{
                  "system" : "https://gematik.de/fhir/sid/emp-identifier"
                }
                38. MedicationRequest.status
                Shortactive | on-hold | completed | entered-in-error | stopped
                BindingThe codes SHALL be taken from eMP MedicationRequest Status Value Set
                (required to https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs)
                Must Supporttrue
                40. MedicationRequest.intent
                Shortplan
                Pattern Valueplan
                42. MedicationRequest.medication[x]
                ShortArzneimittel, welches geplant wird
                TypeReference(EPA Medication), CodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Must Supporttrue
                44. MedicationRequest.subject
                TypeReference(Patient)
                Must Supporttrue
                46. MedicationRequest.subject.identifier
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..?
                TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
                Must Supporttrue
                48. MedicationRequest.authoredOn
                Control1..?
                Must Supporttrue
                Invariantsepa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
                50. MedicationRequest.reasonCode
                Control0..1
                Must Supporttrue
                52. MedicationRequest.reasonCode.coding
                Must Supporttrue
                SlicingThis element introduces a set of slices on MedicationRequest.reasonCode.coding. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • pattern @ $this
                • 54. MedicationRequest.reasonCode.coding:icd-10-gm
                  Slice Nameicd-10-gm
                  Definition

                  Der ICD-Code ist in Deutschland das abrechnungsrelevante Code System im ambulanten und stationären Bereich.

                  Control0..1
                  TypeCoding(Coding-Profil für ICD-10-GM)
                  Must Supporttrue
                  Pattern Value{
                    "system" : "http://fhir.de/CodeSystem/bfarm/icd-10-gm"
                  }
                  56. MedicationRequest.reasonCode.coding:icd-10-gm.system
                  Must Supporttrue
                  58. MedicationRequest.reasonCode.coding:icd-10-gm.version
                  NoteThis is a business version Id, not a resource version Id (see discussion)
                  Must Supporttrue
                  60. MedicationRequest.reasonCode.coding:icd-10-gm.code
                  Must Supporttrue
                  62. MedicationRequest.reasonCode.coding:icd-10-gm.display
                  Control1..?
                  Must Supporttrue
                  64. MedicationRequest.note
                  ShortZusätzliche Informationen durch einen Leistungserbringenden
                  Control0..1
                  Must Supporttrue
                  66. MedicationRequest.note.time
                  Comments

                  This information should be generated automatically

                  Must Supporttrue
                  68. MedicationRequest.note.text
                  Must Supporttrue
                  70. MedicationRequest.dosageInstruction
                  Definition

                  Hier werden Informationen zur Dosierung angegeben.

                  ShortHier werden Informationen zur Dosierung angegeben.
                  Control1..?
                  TypeDosage(Dosage dgMP)
                  Must Supporttrue

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

                  0. MedicationRequest
                  Definition

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

                  ShortOrdering of medication for patient or group
                  Control0..*
                  Is Modifierfalse
                  Summaryfalse
                  Alternate NamesPrescription, Order
                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                  dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                  dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                  2. MedicationRequest.id
                  Definition

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

                  ShortLogical id of this artifact
                  Comments

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

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

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

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

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

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

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

                  ShortAdditional content defined by implementations
                  Comments

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

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

                    The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                    ShortVersion specific identifier
                    Comments

                    The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

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

                    When the resource last changed - e.g. when the version changed.

                    ShortWhen the resource version last changed
                    Comments

                    This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeinstant
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    14. MedicationRequest.meta.source
                    Definition

                    A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                    ShortIdentifies where the resource comes from
                    Comments

                    In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                    This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

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

                    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                    ShortProfiles this resource claims to conform to
                    Comments

                    It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

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

                    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                    ShortSecurity Labels applied to this resource
                    Comments

                    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    20. MedicationRequest.meta.tag
                    Definition

                    Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                    ShortTags applied to this resource
                    Comments

                    The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see CommonTags
                    (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

                    Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

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

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

                    ShortA set of rules under which this content was created
                    Comments

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

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

                    The base language in which the resource is written.

                    ShortLanguage of the resource content
                    Comments

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

                    Control0..1
                    BindingThe codes SHOULD be taken from CommonLanguages
                    (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                    A human language.

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

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

                    ShortText summary of the resource, for human interpretation
                    Comments

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

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

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

                    ShortContained, inline Resources
                    Comments

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

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

                    An Extension

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

                      Extension for indicating the context.

                      ShortExtension
                      Control1..1
                      TypeExtension(ContextExtension) (Extension Type: code)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      34. MedicationRequest.extension:context.id
                      Definition

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

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

                      An Extension

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

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

                        Shortidentifies the meaning of the extension
                        Comments

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

                        Control1..1
                        Typeuri
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
                        40. MedicationRequest.extension:context.value[x]
                        Definition

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

                        ShortContext of the resource
                        Control1..1
                        This element is affected by the following invariants: ele-1
                        BindingThe codes SHALL be taken from Context Codes
                        (required to https://gematik.de/fhir/epa-medication/ValueSet/context-code)
                        Typecode
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Pattern ValueEMP
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        42. MedicationRequest.extension:activity
                        Slice Nameactivity
                        Definition

                        Bildet eine Aktivität in bezug auf ein EMPMedicationRequest ab

                        ShortAktivität die zu diesem Planelement gehört
                        Control0..*
                        TypeExtension(EMPMedicationRequestActitvityExtension) (Complex Extension)
                        Is Modifierfalse
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        44. MedicationRequest.extension:reasonPatientInstruction
                        Slice NamereasonPatientInstruction
                        Definition

                        Benennt den Behandlungsanlass für das Arzneimittel in versichertenverständlicher Form und unterstützt so Verständnis und Wiedererkennung auf dem eMP. Ergänzend angegebene ICD-10-Codes enthalten oft vergleichbare Informationen in medizinischer Fachsprache.

                        ShortPatientenlesbarer Grund für den Planungseintrag
                        Control0..1
                        TypeExtension(ReasonPatientInstructionExtension) (Extension Type: string)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        46. MedicationRequest.extension:patientNote
                        Slice NamepatientNote
                        Definition

                        Übergeordnete Hinweise zur Therapie mit dem zugeordneten Arzneimittel; sie richten sich an den Versicherten, sind aber nicht der Dosierung zuzuordnen. Hierzu gehören bspw. mögliche unerwünschte Arzneimittelwirkungen, Empfehlungen zu regelmäßigen Kontrolluntersuchungen oder zur korrekten Lagerung des Arzneimittels.

                        ShortHinweis für den Patienten
                        Control0..1
                        TypeExtension(PatientNoteExtension) (Extension Type: Annotation)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        48. MedicationRequest.extension:effectiveDosePeriod
                        Slice NameeffectiveDosePeriod
                        Definition

                        Zeitraum, über den die Medikation eingenommen werden soll. Wenn mehrere dosageInstruction-Zeilen vorhanden sind (z. B. bei einer ausschleichenden Dosierung), entspricht dieser Zeitraum dem frühesten Startdatum und dem spätesten Enddatum der dosageInstructions.

                        ShortZeitraum, in dem die Medikation eingenommen werden soll.
                        Control0..1
                        TypeExtension(Extension Definition for MedicationRequest.effectiveDosePeriod for Version 5.0) (Extension Type: Period)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        50. MedicationRequest.extension:effectiveDosePeriod.id
                        Definition

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

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

                        An Extension

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

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

                          Shortidentifies the meaning of the extension
                          Comments

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

                          Control1..1
                          Typeuri
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
                          56. MedicationRequest.extension:effectiveDosePeriod.value[x]
                          Definition

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

                          ShortValue of extension
                          Control1..1
                          This element is affected by the following invariants: ele-1
                          TypePeriod
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          58. MedicationRequest.extension:effectiveDosePeriod.value[x].id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          60. MedicationRequest.extension:effectiveDosePeriod.value[x].extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

                            The start of the period. The boundary is inclusive.

                            ShortStarting time with inclusive boundary
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: per-1
                            TypedateTime
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            epa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
                            64. MedicationRequest.extension:effectiveDosePeriod.value[x].end
                            Definition

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

                            ShortEnd time with inclusive boundary, if not ongoing
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: per-1
                            TypedateTime
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            epa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
                            66. MedicationRequest.extension:renderedDosageInstruction
                            Slice NamerenderedDosageInstruction
                            Definition

                            Ein menschenlesbarer, vollständiger Text der Dosierungsanweisungen. Der Text wird aus den strukturierten Dosage-Elementen generiert und dient der patientensicheren Darstellung der Dosierung. Er soll die maschinenlesbaren Angaben konsistent wiedergeben und in einer für Patient:innen verständlichen Form bereitstellen.

                            ShortVollständige Darstellung der Dosierungsanweisungen (generiert aus den Dosage-Elementen).
                            Control0..1
                            TypeExtension(Extension Definition for MedicationRequest.renderedDosageInstruction for Version 5.0) (Extension Type: markdown)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            68. MedicationRequest.extension:generatedDosageInstructionsMeta
                            Slice NamegeneratedDosageInstructionsMeta
                            Definition

                            Diese Extension enthält zusätzliche Metadaten zu den automatisch generierten Dosierungsanweisungen, wie z.B. Informationen zur Generierung oder zum Ursprung der Daten.

                            ShortMetadaten zu den generierten Dosierungsanweisungen
                            Control0..1
                            TypeExtension(Generated Dosage Instructions Meta) (Complex Extension)
                            Is Modifierfalse
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            70. MedicationRequest.extension:originMedication
                            Slice NameoriginMedication
                            Definition

                            Zeigt auf die Medication-Instanz, die als Grundlage für diesen MedicationRequest diente und stellt so den Ursprung (Origin) des eMP-Eintrags dar.

                            ShortReferenz auf die Ursprungs-Medication (Basis des eMP-Eintrags)
                            Control0..1
                            TypeExtension(Origin Medication Reference (eMP)) (Extension Type: Reference(Medication))
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            72. MedicationRequest.modifierExtension
                            Definition

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

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

                            ShortExtensions that cannot be ignored
                            Comments

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

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

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

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

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

                              ShortExternal ids for this request
                              Comments

                              This is a business identifier, not a resource identifier.

                              NoteThis is a business identifier, not a resource identifier (see discussion)
                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeIdentifier
                              Is Modifierfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ $this
                              • 76. MedicationRequest.identifier:MedicationPlanIdentifier
                                Slice NameMedicationPlanIdentifier
                                Definition

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

                                ShortExternal ids for this request
                                Comments

                                This is a business identifier, not a resource identifier.

                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypeIdentifier(Profil für den Identifikator eines eMP-Eintrags)
                                Is Modifierfalse
                                Must Supporttrue
                                Pattern Value{
                                  "system" : "https://gematik.de/fhir/sid/emp-identifier"
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                78. MedicationRequest.status
                                Definition

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

                                Shortactive | on-hold | completed | entered-in-error | stopped
                                Comments

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

                                Control1..1
                                BindingThe codes SHALL be taken from eMP MedicationRequest Status Value Set
                                (required to https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs)
                                Typecode
                                Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                80. MedicationRequest.statusReason
                                Definition

                                Captures the reason for the current state of the MedicationRequest.

                                ShortReason for current status
                                Comments

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

                                Control0..1
                                This element is affected by the following invariants: ele-1
                                BindingFor example codes, see medicationRequest Status Reason Codes
                                (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1)

                                Identifies the reasons for a given status.

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

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

                                Shortplan
                                Comments

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

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

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

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

                                The kind of medication order.

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

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

                                ShortType of medication usage
                                Comments

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

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                BindingFor example codes, see medicationRequest Category Codes
                                (example to http://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1)

                                A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.

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

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

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

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

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

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

                                ShortTrue if request is prohibiting action
                                Comments

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

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

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

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

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

                                ShortArzneimittel, welches geplant wird
                                Comments

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

                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeReference(EPA Medication)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                94. MedicationRequest.subject
                                Definition

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

                                ShortWho or group medication request is for
                                Comments

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

                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeReference(Patient)
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ref-1: 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')))
                                96. MedicationRequest.subject.id
                                Definition

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                  ShortLiteral reference, Relative, internal or absolute URL
                                  Comments

                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                  Control0..1
                                  This element is affected by the following invariants: ref-1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  102. MedicationRequest.subject.type
                                  Definition

                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                  ShortType the reference refers to (e.g. "Patient")
                                  Comments

                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                  Control0..1
                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                  Aa resource (or, for logical models, the URI of the logical model).

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

                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                  ShortLogical reference, when literal reference is not known
                                  Comments

                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  TypeIdentifier(Identifier-Profil für die 10-stellige Krankenversichertennummer)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  106. MedicationRequest.subject.display
                                  Definition

                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                  ShortText alternative for the resource
                                  Comments

                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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

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

                                  ShortEncounter created as part of encounter/admission/stay
                                  Comments

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

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeReference(Encounter)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ref-1: 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')))
                                  110. MedicationRequest.supportingInformation
                                  Definition

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

                                  ShortInformation to support ordering of the medication
                                  Comments

                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  TypeReference(Resource)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ref-1: 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')))
                                  112. MedicationRequest.authoredOn
                                  Definition

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

                                  ShortWhen request was initially authored
                                  Control1..1
                                  TypedateTime
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  epa-datetime: dateTime muss mindestens aus Tag, Monat und Jahr bestehen (toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$'))
                                  114. MedicationRequest.requester
                                  Definition

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

                                  ShortWho/What requested the Request
                                  Comments

                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ref-1: 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')))
                                  116. MedicationRequest.performer
                                  Definition

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

                                  ShortIntended performer of administration
                                  Comments

                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ref-1: 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')))
                                  118. MedicationRequest.performerType
                                  Definition

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

                                  ShortDesired kind of performer of the medication administration
                                  Comments

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

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  BindingFor example codes, see ProcedurePerformerRoleCodes
                                  (example to http://hl7.org/fhir/ValueSet/performer-role|4.0.1)

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

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

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

                                  ShortPerson who entered the request
                                  Comments

                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeReference(Practitioner, PractitionerRole)
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ref-1: 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')))
                                  122. MedicationRequest.reasonCode
                                  Definition

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

                                  ShortReason or indication for ordering or not ordering the medication
                                  Comments

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

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                  (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                  A coded concept indicating why the medication was ordered.

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

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeCoding
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on MedicationRequest.reasonCode.coding. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                    • pattern @ $this
                                    • 130. MedicationRequest.reasonCode.coding:icd-10-gm
                                      Slice Nameicd-10-gm
                                      Definition

                                      Der ICD-Code ist in Deutschland das abrechnungsrelevante Code System im ambulanten und stationären Bereich.

                                      ShortCode defined by a terminology system
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeCoding(Coding-Profil für ICD-10-GM)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                      Pattern Value{
                                        "system" : "http://fhir.de/CodeSystem/bfarm/icd-10-gm"
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      132. MedicationRequest.reasonCode.coding:icd-10-gm.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      134. MedicationRequest.reasonCode.coding:icd-10-gm.extension
                                      Definition

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

                                      ShortAdditional content defined by implementations
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on MedicationRequest.reasonCode.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 136. MedicationRequest.reasonCode.coding:icd-10-gm.extension:Mehrfachcodierungs-Kennzeichen
                                        Slice NameMehrfachcodierungs-Kennzeichen
                                        Definition

                                        Optional Extension Element - found in all resources.

                                        ShortOptional Extensions Element
                                        Comments

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

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Mehrfachkodierungs-Kennzeichen bei ICD-10-gm) (Extension Type: Coding)
                                        Is Modifierfalse
                                        Standard StatusNormative (from Trial Use)
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        138. MedicationRequest.reasonCode.coding:icd-10-gm.extension:Seitenlokalisation
                                        Slice NameSeitenlokalisation
                                        Definition

                                        Optional Extension Element - found in all resources.

                                        ShortOptional Extensions Element
                                        Comments

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

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(ExtensionSeitenlokalisation) (Extension Type: Coding)
                                        Is Modifierfalse
                                        Standard StatusNormative (from Trial Use)
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        140. MedicationRequest.reasonCode.coding:icd-10-gm.extension:Diagnosesicherheit
                                        Slice NameDiagnosesicherheit
                                        Definition

                                        Optional Extension Element - found in all resources.

                                        ShortOptional Extensions Element
                                        Comments

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

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Extension zur Erfassung der Diagnosesicherheit gemäß KBV-Kodierrichtlinien) (Extension Type: Coding)
                                        Is Modifierfalse
                                        Standard StatusNormative (from Trial Use)
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        142. MedicationRequest.reasonCode.coding:icd-10-gm.system
                                        Definition

                                        The identification of the code system that defines the meaning of the symbol in the code.

                                        ShortCanonische CodeSystem URL für ICD-10-GM
                                        Comments

                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                        Need to be unambiguous about the source of the definition of the symbol.

                                        Fixed Valuehttp://fhir.de/CodeSystem/bfarm/icd-10-gm
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        144. MedicationRequest.reasonCode.coding:icd-10-gm.version
                                        Definition

                                        Bie Verwendung von ICD-10-GM ist die Angabe der Version zwingend erforderlich. Hierdurch wird der Tatsache Rechnung getragen, dass jede der jährlich neu erscheinenden Fassung von ICD-10-GM ein neues Codesystem darstellt.

                                        ShortDie Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
                                        Comments

                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        Control1..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        146. MedicationRequest.reasonCode.coding:icd-10-gm.code
                                        Definition

                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                        ShortDer ICD-10-Code
                                        Control1..1
                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to refer to a particular code in the system.

                                        ExampleEinfacher ICD-Code: F17.4
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        icd-regex: In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt (matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$'))
                                        148. MedicationRequest.reasonCode.coding:icd-10-gm.display
                                        Definition

                                        A representation of the meaning of the code in the system, following the rules of the system.

                                        ShortRepresentation defined by the system
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

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

                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        150. MedicationRequest.reasonCode.coding:icd-10-gm.userSelected
                                        Definition

                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                        ShortIf this coding was chosen directly by the user
                                        Comments

                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                        Control0..1
                                        Typeboolean
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                                        Condition or observation that supports why the medication was ordered.

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

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

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Condition, Observation)
                                        Is Modifierfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: 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')))
                                        156. MedicationRequest.instantiatesCanonical
                                        Definition

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

                                        ShortInstantiates FHIR protocol or definition
                                        Comments

                                        see Canonical References

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

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

                                        ShortInstantiates external protocol or definition
                                        Comments

                                        see http://en.wikipedia.org/wiki/Uniform_resource_identifier

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

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

                                        ShortWhat request fulfills
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: 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')))
                                        162. MedicationRequest.groupIdentifier
                                        Definition

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

                                        ShortComposite request this is part of
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

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

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

                                        ShortOverall pattern of medication administration
                                        Comments

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

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        BindingFor example codes, see medicationRequest Course of Therapy Codes
                                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy|4.0.1)

                                        Identifies the overall pattern of medication administratio.

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

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

                                        ShortAssociated insurance coverage
                                        Comments

                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Coverage, ClaimResponse)
                                        Is Modifierfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ref-1: 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')))
                                        168. MedicationRequest.note
                                        Definition

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

                                        ShortZusätzliche Informationen durch einen Leistungserbringenden
                                        Comments

                                        For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeAnnotation
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        170. MedicationRequest.note.id
                                        Definition

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

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

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

                                        ShortAdditional content defined by implementations
                                        Comments

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

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

                                          The individual responsible for making the annotation.

                                          ShortIndividual responsible for the annotation
                                          Comments

                                          Organization is used when there's no need for specific attribution as to who made the comment.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          176. MedicationRequest.note.time
                                          Definition

                                          Indicates when this particular annotation was made.

                                          ShortWhen the annotation was made
                                          Comments

                                          This information should be generated automatically

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

                                          The text of the annotation in markdown format.

                                          ShortThe annotation - text content (as markdown)
                                          Comments

                                          Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

                                          Control1..1
                                          Typemarkdown
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          180. MedicationRequest.dosageInstruction
                                          Definition

                                          Hier werden Informationen zur Dosierung angegeben.

                                          ShortHier werden Informationen zur Dosierung angegeben.
                                          Comments

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

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

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

                                          ShortMedication supply authorization
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          184. MedicationRequest.dispenseRequest.id
                                          Definition

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

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

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

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

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

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

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

                                            ShortFirst fill details
                                            Comments

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

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            192. MedicationRequest.dispenseRequest.initialFill.id
                                            Definition

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

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

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

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

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

                                              ShortFirst fill quantity
                                              Comments

                                              The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeQuantity(SimpleQuantity)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                              sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                              200. MedicationRequest.dispenseRequest.initialFill.duration
                                              Definition

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

                                              ShortFirst fill duration
                                              Comments

                                              The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                              Control0..1
                                              TypeDuration
                                              Is Modifierfalse
                                              Invariantsdrt-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. (code.exists() implies ((system = %ucum) and value.exists()))
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                              202. MedicationRequest.dispenseRequest.dispenseInterval
                                              Definition

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

                                              ShortMinimum period of time between dispenses
                                              Comments

                                              The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                              Control0..1
                                              TypeDuration
                                              Is Modifierfalse
                                              Invariantsdrt-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. (code.exists() implies ((system = %ucum) and value.exists()))
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                              204. MedicationRequest.dispenseRequest.validityPeriod
                                              Definition

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

                                              ShortTime period supply is authorized for
                                              Comments

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

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypePeriod
                                              Is Modifierfalse
                                              Requirements

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                              206. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                                              Definition

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

                                              ShortNumber of refills authorized
                                              Comments

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

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

                                              The amount that is to be dispensed for one fill.

                                              ShortAmount of medication to supply per dispense
                                              Comments

                                              The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeQuantity(SimpleQuantity)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                              sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                              210. MedicationRequest.dispenseRequest.expectedSupplyDuration
                                              Definition

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

                                              ShortNumber of days supply per dispense
                                              Comments

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

                                              Control0..1
                                              TypeDuration
                                              Is Modifierfalse
                                              Invariantsdrt-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. (code.exists() implies ((system = %ucum) and value.exists()))
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                              212. MedicationRequest.dispenseRequest.performer
                                              Definition

                                              Indicates the intended dispensing Organization specified by the prescriber.

                                              ShortIntended dispenser
                                              Comments

                                              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(Organization)
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: 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')))
                                              214. MedicationRequest.substitution
                                              Definition

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

                                              ShortAny restrictions on medication substitution
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              216. MedicationRequest.substitution.id
                                              Definition

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

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

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

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

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

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

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

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

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

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

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

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

                                                ShortWhether substitution is allowed or not
                                                Comments

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

                                                Control1..1
                                                This element is affected by the following invariants: ele-1
                                                BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                                (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                                Identifies the type of substitution allowed.

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

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

                                                ShortWhy should (not) substitution be made
                                                Comments

                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                BindingFor example codes, see SubstanceAdminSubstitutionReason
                                                (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

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

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

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

                                                ShortAn order/prescription that is being replaced
                                                Comments

                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeReference(MedicationRequest)
                                                Is Modifierfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ref-1: 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')))
                                                228. MedicationRequest.detectedIssue
                                                Definition

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

                                                ShortClinical Issue with action
                                                Comments

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

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeReference(DetectedIssue)
                                                Is Modifierfalse
                                                Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ref-1: 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')))
                                                230. MedicationRequest.eventHistory
                                                Definition

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

                                                ShortA list of events of interest in the lifecycle
                                                Comments

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

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeReference(Provenance)
                                                Is Modifierfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ref-1: 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')))