Implementation Guide
ePA Medication Service
Version 1.3.0 - release

## Extension: MultiplePrescription

Official URL: https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension | Version: 1.3.0
Active as of 2025-12-15 | Computable Name: MultiplePrescriptionExtension
Copyright/Legal: gematik GmbH / Dieses Artefakt ist lizenziert unter Apache License, Version 2.0.

This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.

Context of Use

This extension may be used on the following element(s):

- Element ID Element

Usage info

Usages:

- Use this Extension: EPA MedicationRequest
- Examples for this Extension: Bundle/example-get-medication-list-bundle1, Bundle/example-get-medication-plan-bundle-1, Bundle/example-searchset-medicationrequest, MedicationRequest/0435e19e-ed9a-4b5b-a9e9-70924c5922a0... Show 14 more, MedicationRequest/08cb8487-2758-406c-999a-e23a05e63c0b, MedicationRequest/0e7f16e4-d879-4a2c-8292-41c55201bbdd, MedicationRequest/2a794a78-8a72-46ca-bb81-09f702f94e11, MedicationRequest/3191d752-3adf-4c7f-848d-8d43766fed72, MedicationRequest/3ffb5c34-81e7-45ec-842c-82a2422cb8c8, MedicationRequest/40df19aa-40e2-4ebc-a11d-9d232dcb0f67, MedicationRequest/4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8, MedicationRequest/6461edff-13ec-4dc7-b9f3-aea66bcb0643, MedicationRequest/7efae80a-a4d9-4e26-a1b9-92c72e79cfaa, MedicationRequest/ed2eeb8c-9ab6-4f4f-be9d-7e1a3784045e, MedicationRequest/f14498f0-4932-490a-91a2-9de8616e133b, MedicationRequest/f6b1d9ab-4ff0-405e-8d2d-7a181d9fdbdd, Parameters/example-epa-op-provide-prescription-erp-input-parameters-1 and Parameters/example-epa-op-provide-prescription-erp-input-parameters-2

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

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

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from Extension

Summary

Complex Extension: This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.

- indicator: boolean: An Extension
- counter: Ratio: An Extension
- period: Period: An Extension
- id: Identifier: An Extension

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | MultiplePrescription
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Closed by value:url
extension:indicator |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "counter"
value[x] |  | 1..1 | Ratio | Value of extension
numerator |  | 1..1 | Quantity | Numerator value
value |  | 1..1 | decimal | Multiple Prescription Counter
comparator |  | 0..0 |  | < | <= | >= | > - how to understand the value
unit |  | 0..0 |  | Unit representation
system |  | 0..0 |  | System that defines coded unit form
code |  | 0..0 |  | Coded form of the unit
denominator |  | 1..1 | Quantity | Denominator value
value |  | 1..1 | decimal | Denominator of Multiple Prescription Series
comparator |  | 0..0 |  | < | <= | >= | > - how to understand the value
unit |  | 0..0 |  | Unit representation
system |  | 0..0 |  | System that defines coded unit form
code |  | 0..0 |  | Coded form of the unit
extension:period |  | 0..1 | Extension | Zeitraum der Einlösefrist
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "period"
value[x] | C | 1..1 | Period | Value of extension Constraints: -limitationDateStart, -limitationDateEnd
start |  | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end |  | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "id"
value[x] |  | 1..1 | Identifier | Value of extension
use |  | 0..0 |  | usual | official | temp | secondary | old (If known)
type |  | 0..0 |  | Description of identifier
system |  | 0..1 | uri | Specification as UUID Fixed Value: urn:ietf:rfc:3986
value |  | 0..1 | string | Multiple Prescription ID
period |  | 0..0 |  | Time period when id is/was valid for use
assigner |  | 0..0 |  | Organization that issued id (may be just text)
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | MultiplePrescription
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Closed by value:url
extension:indicator |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "counter"
value[x] |  | 1..1 | Ratio | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
numerator | Σ C | 1..1 | Quantity | Numerator value Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | Σ | 1..1 | decimal | Multiple Prescription Counter
denominator | Σ C | 1..1 | Quantity | Denominator value Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | Σ | 1..1 | decimal | Denominator of Multiple Prescription Series
extension:period |  | 0..1 | Extension | Zeitraum der Einlösefrist
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "period"
value[x] | C | 1..1 | Period | Value of extension Constraints: -limitationDateStart, -limitationDateEnd
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | Σ C | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end | Σ C | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "id"
value[x] |  | 1..1 | Identifier | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Specification as UUID Fixed Value: urn:ietf:rfc:3986
value | Σ | 0..1 | string | Multiple Prescription ID Example General: 123456
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This FHIR Extension for multiple prescriptions adds details such as repetition count and time intervals for repeated medication orders to FHIR resources.

- indicator: boolean: An Extension
- counter: Ratio: An Extension
- period: Period: An Extension
- id: Identifier: An Extension

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | MultiplePrescription
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Closed by value:url
extension:indicator |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "counter"
value[x] |  | 1..1 | Ratio | Value of extension
numerator |  | 1..1 | Quantity | Numerator value
value |  | 1..1 | decimal | Multiple Prescription Counter
comparator |  | 0..0 |  | < | <= | >= | > - how to understand the value
unit |  | 0..0 |  | Unit representation
system |  | 0..0 |  | System that defines coded unit form
code |  | 0..0 |  | Coded form of the unit
denominator |  | 1..1 | Quantity | Denominator value
value |  | 1..1 | decimal | Denominator of Multiple Prescription Series
comparator |  | 0..0 |  | < | <= | >= | > - how to understand the value
unit |  | 0..0 |  | Unit representation
system |  | 0..0 |  | System that defines coded unit form
code |  | 0..0 |  | Coded form of the unit
extension:period |  | 0..1 | Extension | Zeitraum der Einlösefrist
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "period"
value[x] | C | 1..1 | Period | Value of extension Constraints: -limitationDateStart, -limitationDateEnd
start |  | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end |  | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "id"
value[x] |  | 1..1 | Identifier | Value of extension
use |  | 0..0 |  | usual | official | temp | secondary | old (If known)
type |  | 0..0 |  | Description of identifier
system |  | 0..1 | uri | Specification as UUID Fixed Value: urn:ietf:rfc:3986
value |  | 0..1 | string | Multiple Prescription ID
period |  | 0..0 |  | Time period when id is/was valid for use
assigner |  | 0..0 |  | Organization that issued id (may be just text)
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | MultiplePrescription
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Closed by value:url
extension:indicator |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "indicator"
value[x] |  | 1..1 | boolean | Multiple Prescription Indicator
extension:counter |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "counter"
value[x] |  | 1..1 | Ratio | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
numerator | Σ C | 1..1 | Quantity | Numerator value Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | Σ | 1..1 | decimal | Multiple Prescription Counter
denominator | Σ C | 1..1 | Quantity | Denominator value Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | Σ | 1..1 | decimal | Denominator of Multiple Prescription Series
extension:period |  | 0..1 | Extension | Zeitraum der Einlösefrist
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "period"
value[x] | C | 1..1 | Period | Value of extension Constraints: -limitationDateStart, -limitationDateEnd
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | Σ C | 1..1 | dateTime | Start Date of the Prescription Redemption Period
end | Σ C | 0..1 | dateTime | End Date of the Prescription Redemption Period
extension:id |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "id"
value[x] |  | 1..1 | Identifier | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Specification as UUID Fixed Value: urn:ietf:rfc:3986
value | Σ | 0..1 | string | Multiple Prescription ID Example General: 123456
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Constraints

Id | Grade | Path(s) | Description | Expression
-limitationDateEnd | error | Extension.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD | `end.exists().not() or end.toString().length()=10`
-limitationDateStart | error | Extension.extension:period.value[x] | Limitation of the date format to 10 characters YYYY-MM-DD | `start.toString().length()=10`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
qty-3 | error | Extension.extension:counter.value[x].numerator, Extension.extension:counter.value[x].denominator | If a code for the unit is present, the system SHALL also be present | `code.empty() or system.exists()`