Implementation Guide
ePA Medication Service
Version 1.3.1 - release

Resource Profile: EPAMedicationRequest - Detailed Descriptions

Active as of 2025-12-15

Definitions for the epa-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:multiplePrescription
Slice NamemultiplePrescription
Definition

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

ShortMultiplePrescription
Control0..1
TypeExtension(MultiplePrescription) (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())
12. MedicationRequest.extension:multiplePrescription.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..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifierfalse
Must Supporttrue
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 ClosedOpen, and can be differentiated using the following discriminators:
  • value @ url
  • 14. MedicationRequest.extension:multiplePrescription.extension:indicator
    Slice Nameindicator
    Definition

    An Extension

    ShortExtensionAdditional content defined by implementations
    Control0..1*
    This element is affected by the following invariants: ele-1
    TypeExtension
    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())
    16. MedicationRequest.extension:multiplePrescription.extension:indicator.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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. MedicationRequest.extension:multiplePrescription.extension:indicator.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
      Must Supporttrue
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valueindicator
      20. MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]
      Definition

      Indicator of whether the current prescription is part of a multiple prescription

      true - the current prescription is part of a multiple prescription false - the current prescription is not part of a multiple prescription


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

      ShortMultiple Prescription IndicatorValue of extension
      Control10..1
      This element is affected by the following invariants: ele-1
      Typeboolean, 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, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, 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
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. MedicationRequest.extension:multiplePrescription.extension:counter
      Slice Namecounter
      Definition

      An Extension

      ShortExtensionAdditional content defined by implementations
      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeExtension
      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:multiplePrescription.extension:counter.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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 26. MedicationRequest.extension:multiplePrescription.extension:counter.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
        Must Supporttrue
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed Valuecounter
        28. MedicationRequest.extension:multiplePrescription.extension:counter.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
        TypeRatio, 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, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, 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
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator
        Definition

        The value of the numerator.

        ShortNumerator value
        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.

        Control10..1
        This element is affected by the following invariants: ele-1
        TypeQuantity
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        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())
        32. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value
        Definition

        The field serves to indicate which number in a series of multiple prescriptions it is. Example: "2" in "2 out of 4"


        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

        ShortMultiple Prescription CounterNumerical value (with implicit precision)
        Comments

        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

        Precision is handled implicitly in almost all cases of measurement.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.comparator
        Definition

        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

        Short< | <= | >= | > - how to understand the value
        Control0..01
        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

        How the Quantity should be understood and represented.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

        Meaning if MissingIf there is no comparator, then there is no modification of the value
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.unit
        Definition

        A human-readable form of the unit.

        ShortUnit representation
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.system
        Definition

        The identification of the system that provides the coded form of the unit.

        ShortSystem that defines coded unit form
        Comments

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

        Control0..01
        This element is affected by the following invariants: qty-3
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to know the system that defines the coded form of the unit.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.code
        Definition

        A computer processable form of the unit in some unit representation system.

        ShortCoded form of the unit
        Comments

        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

        Control0..01
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator
        Definition

        The value of the denominator.

        ShortDenominator value
        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.

        Control10..1
        This element is affected by the following invariants: ele-1
        TypeQuantity
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        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())
        44. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value
        Definition

        The field serves to indicate the length of this series. Example: "4" in "2 out of 4"


        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

        ShortDenominator of Multiple Prescription SeriesNumerical value (with implicit precision)
        Comments

        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

        Precision is handled implicitly in almost all cases of measurement.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.comparator
        Definition

        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

        Short< | <= | >= | > - how to understand the value
        Control0..01
        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

        How the Quantity should be understood and represented.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

        Meaning if MissingIf there is no comparator, then there is no modification of the value
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.unit
        Definition

        A human-readable form of the unit.

        ShortUnit representation
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.system
        Definition

        The identification of the system that provides the coded form of the unit.

        ShortSystem that defines coded unit form
        Comments

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

        Control0..01
        This element is affected by the following invariants: qty-3
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to know the system that defines the coded form of the unit.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.code
        Definition

        A computer processable form of the unit in some unit representation system.

        ShortCoded form of the unit
        Comments

        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

        Control0..01
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. MedicationRequest.extension:multiplePrescription.extension:period
        Slice Nameperiod
        Definition

        An Extension

        ShortExtensionAdditional content defined by implementations
        Control0..1*
        This element is affected by the following invariants: ele-1
        TypeExtension
        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())
        56. MedicationRequest.extension:multiplePrescription.extension:period.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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 58. MedicationRequest.extension:multiplePrescription.extension:period.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
          Must Supporttrue
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valueperiod
          60. MedicationRequest.extension:multiplePrescription.extension:period.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
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD (start.toString().length()=10)
          -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD (end.exists().not() or end.toString().length()=10)
          62. MedicationRequest.extension:multiplePrescription.extension:period.value[x].start
          Definition

          Date from which the partial prescription of the multiple prescription can be redeemed


          The start of the period. The boundary is inclusive.

          ShortStart Date of the Prescription Redemption PeriodStarting time with inclusive boundary
          Comments

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

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

          Date of the last redemption day for the partial prescription within the multiple prescription series. The issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV)


          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 Date of the Prescription Redemption PeriodEnd 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
          Must Supporttrue
          Summarytrue
          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. MedicationRequest.extension:multiplePrescription.extension:id
          Slice Nameid
          Definition

          An Extension

          ShortExtensionAdditional content defined by implementations
          Control0..1*
          This element is affected by the following invariants: ele-1
          TypeExtension
          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())
          68. MedicationRequest.extension:multiplePrescription.extension:id.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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 70. MedicationRequest.extension:multiplePrescription.extension:id.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
            Must Supporttrue
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valueid
            72. MedicationRequest.extension:multiplePrescription.extension:id.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
            TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, 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
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. MedicationRequest.extension:multiplePrescription.extension:id.value[x].use
            Definition

            The purpose of this identifier.

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

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

            Control0..01
            BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

            Identifies the purpose for this identifier, if known .

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

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. MedicationRequest.extension:multiplePrescription.extension:id.value[x].type
            Definition

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

            ShortDescription of identifier
            Comments

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

            Control0..01
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. MedicationRequest.extension:multiplePrescription.extension:id.value[x].system
            Definition

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

            ShortSpecification as UUIDThe namespace for the identifier value
            Comments

            Identifier.system is always case sensitive.

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

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

            Fixed Valueurn:ietf:rfc:3986
            ExampleGeneral: http://www.acme.com/identifiers/patient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. MedicationRequest.extension:multiplePrescription.extension:id.value[x].value
            Definition

            A unique ID that is identical across all partial prescriptions of a multiple prescription.


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

            ShortMultiple Prescription IDThe value that is unique
            Comments

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

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            ExampleGeneral: 123456
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            82. MedicationRequest.extension:multiplePrescription.extension:id.value[x].period
            Definition

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

            ShortTime period when id is/was valid for use
            Comments

            A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

            Period is not used for a duration (a measure of elapsed time). See Duration.

            Control0..01
            This element is affected by the following invariants: ele-1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            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))
            84. MedicationRequest.extension:multiplePrescription.extension:id.value[x].assigner
            Definition

            Organization that issued/manages the identifier.

            ShortOrganization that issued id (may be just text)
            Comments

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

            Control0..01
            This element is affected by the following invariants: ele-1
            TypeReference(Organization)
            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')))
            86. MedicationRequest.extension:multiplePrescription.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
            Must Supporttrue
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
            88. MedicationRequest.extension:multiplePrescription.value[x]
            Definition

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

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

            Indicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.

            ShortExtension
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(IndicatorBVGExtension) (Extension Type: boolean)
            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())
            92. MedicationRequest.extension:isBvg.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
            • 94. MedicationRequest.extension:isBvg.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
              Must Supporttrue
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension
              96. MedicationRequest.extension:isBvg.value[x]
              Definition

              Indicator of whether this regulation applies to claimants under the 'Bundesentschädigungsgesetz' (BEG) or to claimants under the 'Bundesversorgungsgesetz' (BVG).

              false - not BVG (default value)

              true - BVG


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

              ShortBVGValue of extension
              Control10..1
              This element is affected by the following invariants: ele-1
              Typeboolean, 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, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, 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
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. MedicationRequest.extension:isSer
              Slice NameisSer
              Definition

              Kennzeichnung, ob diese Verordnung mit Bezug zum Sozialen Entschädigungsrecht nach SGB XIV (SER) erfolgt

              ShortExtension
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(IndicatorSERExtension) (Extension Type: boolean)
              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())
              100. MedicationRequest.extension:isSer.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
              • 102. MedicationRequest.extension:isSer.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
                Must Supporttrue
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/indicator-ser-extension
                104. MedicationRequest.extension:isSer.value[x]
                Definition

                Kennzeichnung, ob diese Verordnung mit Bezug zum Sozialen Entschädigungsrecht nach SGB XIV (SER) erfolgt

                false - not SER (default value)

                true - SER


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

                ShortSERValue of extension
                Control10..1
                This element is affected by the following invariants: ele-1
                Typeboolean, 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, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, 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
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. MedicationRequest.extension:prescriberID
                Slice NameprescriberID
                Definition

                Verschreiber-ID, welche bei der Verordnung bestimmter Präparate anzugeben ist, damit die Apotheke das Rezept beliefern darf.

                ShortExtension
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(PrescriberIDExtension) (Extension Type: Identifier)
                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())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                108. MedicationRequest.extension:prescriberID.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
                • 110. MedicationRequest.extension:prescriberID.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
                  Must Supporttrue
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/prescriber-id-extension
                  112. MedicationRequest.extension:prescriberID.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
                  TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, 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
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  114. MedicationRequest.extension:prescriberID.value[x].use
                  Definition

                  The purpose of this identifier.

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

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

                  Control0..01
                  BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                  Identifies the purpose for this identifier, if known .

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

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

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  116. MedicationRequest.extension:prescriberID.value[x].type
                  Definition

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

                  ShortDescription of identifier
                  Comments

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

                  Control0..01
                  This element is affected by the following invariants: ele-1
                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  123. MedicationRequest.extension:prescriberID.value[x].system
                  Definition

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

                  ShortThe namespace for the identifier value
                  Comments

                  Identifier.system is always case sensitive.

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

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

                  ExampleGeneral: http://www.acme.com/identifiers/patient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  125. MedicationRequest.extension:prescriberID.value[x].value
                  Definition

                  Verschreiber-ID, welche bei der Verordnung bestimmter Präparate anzugeben ist, damit die Apotheke das Rezept beliefern darf.


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

                  ShortVerschreiber-IDThe value that is unique
                  Comments

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

                  Control10..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  ExampleGeneral: 123456
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  127. MedicationRequest.extension:prescriberID.value[x].period
                  Definition

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

                  ShortTime period when id is/was valid for use
                  Comments

                  A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                  Period is not used for a duration (a measure of elapsed time). See Duration.

                  Control0..01
                  This element is affected by the following invariants: ele-1
                  TypePeriod
                  Is Modifierfalse
                  Summarytrue
                  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))
                  129. MedicationRequest.extension:prescriberID.value[x].assigner
                  Definition

                  Organization that issued/manages the identifier.

                  ShortOrganization that issued id (may be just text)
                  Comments

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

                  Control0..01
                  This element is affected by the following invariants: ele-1
                  TypeReference(Organization)
                  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')))
                  131. MedicationRequest.extension:patientID
                  Slice NamepatientID
                  Definition

                  Patienten-ID, welche bei der Verordnung bestimmter Arzneimittel angegeben werden kann.

                  ShortExtension
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(PatientIDExtension) (Extension Type: Identifier)
                  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())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  133. MedicationRequest.extension:patientID.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
                  • 135. MedicationRequest.extension:patientID.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
                    Must Supporttrue
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/patient-id-extension
                    137. MedicationRequest.extension:patientID.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
                    TypeIdentifier, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Coding, SampledData, id, positiveInt, Distance, Period, 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
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    139. MedicationRequest.extension:patientID.value[x].use
                    Definition

                    The purpose of this identifier.

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

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

                    Control0..01
                    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                    Identifies the purpose for this identifier, if known .

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

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    141. MedicationRequest.extension:patientID.value[x].type
                    Definition

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

                    ShortDescription of identifier
                    Comments

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

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    148. MedicationRequest.extension:patientID.value[x].system
                    Definition

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

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

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

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

                    ExampleGeneral: http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    150. MedicationRequest.extension:patientID.value[x].value
                    Definition

                    Patienten-ID, welche bei der Verordnung bestimmter Arzneimittel angegeben werden kann.


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

                    ShortPatienten-IDThe value that is unique
                    Comments

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

                    Control10..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    ExampleGeneral: 123456
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    152. MedicationRequest.extension:patientID.value[x].period
                    Definition

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

                    ShortTime period when id is/was valid for use
                    Comments

                    A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                    Period is not used for a duration (a measure of elapsed time). See Duration.

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    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))
                    154. MedicationRequest.extension:patientID.value[x].assigner
                    Definition

                    Organization that issued/manages the identifier.

                    ShortOrganization that issued id (may be just text)
                    Comments

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

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    TypeReference(Organization)
                    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')))
                    156. MedicationRequest.extension:narcotics
                    Slice Namenarcotics
                    Definition

                    Abbildung der Angaben zur Verordnung eines Betäubungsmittels im Sinne des Betäubungsmittelgesetzes (BtMG)

                    ShortBetäubungsmittel (BtM)
                    Control0..1
                    TypeExtension(NarcoticsExtension) (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())
                    158. MedicationRequest.extension:teratogenic
                    Slice Nameteratogenic
                    Definition

                    Abbildung der Angaben zur Verordnung eines teratogenen Arzneimittels (T-Rezept)

                    ShortT-Rezept
                    Control0..1
                    TypeExtension(TeratogenicExtension) (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())
                    160. 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())
                    162. MedicationRequest.extension:renderedDosageInstruction.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
                    • 164. MedicationRequest.extension:renderedDosageInstruction.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
                      Must Supporttrue
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
                      166. MedicationRequest.extension:renderedDosageInstruction.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
                      Typemarkdown, 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, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, 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
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      168. 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())
                      170. MedicationRequest.extension:generatedDosageInstructionsMeta.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.

                      Control20..*
                      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
                      • 172. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language
                        Slice Namelanguage
                        Definition

                        An Extension

                        ShortExtensionAdditional content defined by implementations
                        Control10..1*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        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())
                        174. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.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..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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 176. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.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
                          Must Supporttrue
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Fixed Valuelanguage
                          178. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.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
                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                          [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()))
                          SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 180. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.value[x]:valueCode
                            Slice NamevalueCode
                            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
                            BindingThe codes SHALL be taken from For codes, see AllLanguages
                            (required to http://hl7.org/fhir/ValueSet/all-languages)
                            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
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            182. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion
                            Slice NamealgorithmVersion
                            Definition

                            An Extension

                            ShortExtensionAdditional content defined by implementations
                            Control10..1*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            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())
                            184. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.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..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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 186. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.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
                              Must Supporttrue
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Fixed ValuealgorithmVersion
                              188. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.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
                              TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                              [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()))
                              SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 190. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.value[x]:valueString
                                Slice NamevalueString
                                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
                                Typestring, 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, code, 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
                                Must Supporttrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                192. MedicationRequest.extension:generatedDosageInstructionsMeta.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
                                Must Supporttrue
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Fixed Valuehttp://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta
                                194. MedicationRequest.extension:generatedDosageInstructionsMeta.value[x]
                                Definition

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

                                ShortValue of extension
                                Control0..01
                                This element is affected by the following invariants: ele-1
                                TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                196. 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
                                • 198. 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:
                                  • pattern @ $this
                                  • 200. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
                                    Slice NameRxPrescriptionProcessIdentifier
                                    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(RxPrescriptionProcessIdentifier)
                                    Is Modifierfalse
                                    Pattern Value{
                                      "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    202. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.use
                                    Definition

                                    The purpose of this identifier.

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

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

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

                                    Identifies the purpose for this identifier, if known .

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

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

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

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

                                    ShortDescription of identifier
                                    Comments

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    206. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.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()))
                                    208. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.system
                                    Definition

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

                                    ShortIdentity 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.

                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    210. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.version
                                    Definition

                                    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.

                                    ShortVersion 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)
                                    Control0..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()))
                                    212. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.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).

                                    ShortSymbol in syntax defined by the system
                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    214. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.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

                                    Control0..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()))
                                    216. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.system
                                    Definition

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

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

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

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

                                    Pattern Valuehttps://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    218. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.value
                                    Definition

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

                                    ShortThe value that is unique
                                    Comments

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

                                    Control10..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    ExampleGeneral: 123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    220. MedicationRequest.identifier:RxOriginatorProcessIdentifier
                                    Slice NameRxOriginatorProcessIdentifier
                                    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(RxOriginatorProcessIdentifier)
                                    Is Modifierfalse
                                    Pattern Value{
                                      "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    222. MedicationRequest.identifier:RxOriginatorProcessIdentifier.use
                                    Definition

                                    The purpose of this identifier.

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

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

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

                                    Identifies the purpose for this identifier, if known .

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

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

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

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

                                    ShortDescription of identifier
                                    Comments

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    226. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.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()))
                                    228. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.system
                                    Definition

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

                                    ShortIdentity 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.

                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    230. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.version
                                    Definition

                                    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.

                                    ShortVersion 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)
                                    Control0..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()))
                                    232. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.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).

                                    ShortSymbol in syntax defined by the system
                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    234. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.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

                                    Control0..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()))
                                    236. MedicationRequest.identifier:RxOriginatorProcessIdentifier.system
                                    Definition

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

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

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

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

                                    Pattern Valuehttps://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    238. MedicationRequest.identifier:RxOriginatorProcessIdentifier.value
                                    Definition

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

                                    ShortThe value that is unique
                                    Comments

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

                                    Control10..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    ExampleGeneral: 123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    240. MedicationRequest.status
                                    Definition

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

                                    ShortStatus of Medication Requestactive | 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 TI Medication Request ValueSethttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
                                    (required to https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-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()))
                                    242. MedicationRequest.intent
                                    Definition

                                    e.g. when data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.


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

                                    Shortfiller-orderproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
                                    Comments

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

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

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

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

                                    The kind of medication order.

                                    Typecode
                                    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    244. 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()))
                                    246. MedicationRequest.medication[x]
                                    Definition

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

                                    ShortMedication to be taken
                                    Comments

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

                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    TypeReference(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()))
                                    248. MedicationRequest.medication[x].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
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    250. MedicationRequest.medication[x].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)
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeIdentifier
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    252. MedicationRequest.medication[x].identifier.use
                                    Definition

                                    The purpose of this identifier.

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

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

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

                                    Identifies the purpose for this identifier, if known .

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

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    254. MedicationRequest.medication[x].identifier.type
                                    Definition

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

                                    ShortDescription of identifier
                                    Comments

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    256. MedicationRequest.medication[x].identifier.type.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()))
                                    258. MedicationRequest.medication[x].identifier.type.coding.system
                                    Definition

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

                                    ShortIdentity 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.

                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    260. MedicationRequest.medication[x].identifier.type.coding.version
                                    Definition

                                    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.

                                    ShortVersion 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)
                                    Control0..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()))
                                    262. MedicationRequest.medication[x].identifier.type.coding.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).

                                    ShortSymbol in syntax defined by the system
                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    264. MedicationRequest.medication[x].identifier.type.coding.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

                                    Control0..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()))
                                    266. MedicationRequest.medication[x].identifier.system
                                    Definition

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

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

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

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

                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    268. MedicationRequest.medication[x].identifier.value
                                    Definition

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

                                    ShortThe value that is unique
                                    Comments

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

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    ExampleGeneral: 123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    270. MedicationRequest.medication[x].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
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    272. 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')))
                                    274. 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()))
                                    276. MedicationRequest.authoredOn
                                    Definition

                                    Issue Date of the Prescription


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

                                    ShortIssue DateWhen 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()))
                                    278. 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(Organization, Practitioner, PractitionerRole, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    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')))
                                    280. MedicationRequest.requester.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
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    282. MedicationRequest.requester.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)
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeIdentifier
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    284. MedicationRequest.requester.identifier.use
                                    Definition

                                    The purpose of this identifier.

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

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

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

                                    Identifies the purpose for this identifier, if known .

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

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

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

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

                                    ShortDescription of identifier
                                    Comments

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    288. MedicationRequest.requester.identifier.type.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()))
                                    290. MedicationRequest.requester.identifier.type.coding.system
                                    Definition

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

                                    ShortIdentity 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.

                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    292. MedicationRequest.requester.identifier.type.coding.version
                                    Definition

                                    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.

                                    ShortVersion 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)
                                    Control0..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()))
                                    294. MedicationRequest.requester.identifier.type.coding.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).

                                    ShortSymbol in syntax defined by the system
                                    Control0..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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    296. MedicationRequest.requester.identifier.type.coding.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

                                    Control0..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()))
                                    298. MedicationRequest.requester.identifier.system
                                    Definition

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

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

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

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

                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    300. MedicationRequest.requester.identifier.value
                                    Definition

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

                                    ShortThe value that is unique
                                    Comments

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

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    ExampleGeneral: 123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    302. MedicationRequest.requester.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
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    304. 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(eMP MedicationRequest, CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                                    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')))
                                    306. MedicationRequest.basedOn.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
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    308. MedicationRequest.basedOn.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)
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeIdentifier(Profil für den Identifikator eines eMP-Eintrags)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    310. MedicationRequest.basedOn.identifier.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..01
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    312. MedicationRequest.basedOn.identifier.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..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.basedOn.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 314. MedicationRequest.basedOn.identifier.use
                                      Definition

                                      The purpose of this identifier.

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

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

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

                                      Identifies the purpose for this identifier, if known .

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

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

                                      Fixed Valueofficial
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      316. MedicationRequest.basedOn.identifier.type
                                      Definition

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

                                      ShortDescription of identifier
                                      Comments

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

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type|4.0.1
                                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

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

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      318. MedicationRequest.basedOn.identifier.type.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()))
                                      320. MedicationRequest.basedOn.identifier.type.coding.system
                                      Definition

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

                                      ShortIdentity 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.

                                      Control0..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.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      322. MedicationRequest.basedOn.identifier.type.coding.version
                                      Definition

                                      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.

                                      ShortVersion 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)
                                      Control0..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()))
                                      324. MedicationRequest.basedOn.identifier.type.coding.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).

                                      ShortSymbol in syntax defined by the system
                                      Control0..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.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      326. MedicationRequest.basedOn.identifier.type.coding.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

                                      Control0..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()))
                                      328. MedicationRequest.basedOn.identifier.system
                                      Definition

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

                                      ShortThe namespace for the identifier value
                                      Comments

                                      Identifier.system is always case sensitive.

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

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

                                      Pattern Valuehttps://gematik.de/fhir/sid/emp-identifier
                                      ExampleGeneral: http://www.acme.com/identifiers/patient
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      330. MedicationRequest.basedOn.identifier.value
                                      Definition

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

                                      ShortDer eindeutige IdentifikationswertThe value that is unique
                                      Comments

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

                                      Control10..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      ExampleGeneral: 123456
                                      General: 687512ce-744c-8001-83c3-238227110dd6
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      332. MedicationRequest.basedOn.identifier.period
                                      Definition

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

                                      ShortTime period when id is/was valid for use
                                      Comments

                                      A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                      Period is not used for a duration (a measure of elapsed time). See Duration.

                                      Control0..01
                                      This element is affected by the following invariants: ele-1
                                      TypePeriod
                                      Is Modifierfalse
                                      Summarytrue
                                      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))
                                      334. MedicationRequest.basedOn.identifier.assigner
                                      Definition

                                      Organization that issued/manages the identifier.

                                      ShortOrganization that issued id (may be just text)
                                      Comments

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

                                      Control0..01
                                      This element is affected by the following invariants: ele-1
                                      TypeReference(Organization, Organization)
                                      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')))
                                      336. MedicationRequest.basedOn.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
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      338. MedicationRequest.note
                                      Definition

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

                                      ShortInformation 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()))
                                      340. MedicationRequest.note.text
                                      Definition

                                      Instructions to the pharmacy that go beyond the dosage information


                                      The text of the annotation in markdown format.

                                      ShortDispensing NoteThe 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()))
                                      342. 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.

                                      Control0..*
                                      TypeDosage(Dosage dgMP)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      344. MedicationRequest.dosageInstruction.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..*
                                      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 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())
                                      346. MedicationRequest.dosageInstruction.sequence
                                      Definition

                                      Indicates the order in which the dosage instructions should be applied or interpreted.

                                      ShortThe order of the dosage instructions
                                      Comments

                                      Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                      32 bit number; for values larger than this, use decimal

                                      Control0..01
                                      This element is affected by the following invariants: ele-1
                                      Typeinteger
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

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

                                      Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker


                                      Free text dosage instructions e.g. SIG.

                                      ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'Free text dosage instructions e.g. SIG
                                      Comments

                                      Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.


                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

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

                                      Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                                      ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                                      Comments

                                      Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                                      Control0..0*
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

                                      A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

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

                                      Instructions in terms that are understood by the patient or consumer.

                                      ShortPatient or consumer oriented instructions
                                      Comments

                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                      Control0..01
                                      This element is affected by the following invariants: ele-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()))
                                      354. MedicationRequest.dosageInstruction.timing
                                      Definition

                                      Specifies an event that may occur multiple times. Timing schedules are used to record when things are planned, expected or requested to occur. The most common usage is in dosage instructions for medications. They are also used when planning care of various kinds, and may be used for reporting the schedule to which past regular activities were carried out.


                                      When medication should be administered.

                                      ShortA timing schedule that specifies an event that may occur multiple timesWhen medication should be administered
                                      Comments

                                      Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events.

                                      A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure.


                                      This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeTiming(Timing dgMP)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      356. MedicationRequest.dosageInstruction.asNeeded[x]
                                      Definition

                                      Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                      ShortTake "as needed" (for x)
                                      Comments

                                      Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                      Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                                      Control0..01
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

                                      A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

                                      TypeChoice of: boolean, CodeableConcept
                                      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()))
                                      358. MedicationRequest.dosageInstruction.site
                                      Definition

                                      Body site to administer to.

                                      ShortBody site to administer to
                                      Comments

                                      Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                      If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                                      Control0..01
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

                                      A coded concept describing the site location the medicine enters into or onto the body.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A coded specification of the anatomic site where the medication first enters the body.

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

                                      How drug should enter body.

                                      ShortHow drug should enter body
                                      Comments

                                      Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                      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..01
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

                                      A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

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

                                      Technique for administering medication.

                                      ShortTechnique for administering medication
                                      Comments

                                      Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                      Terminologies used often pre-coordinate this term with the route and or form of administration.

                                      Control0..01
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

                                      A coded concept describing the technique by which the medicine is administered.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

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

                                      Die verabreichte Menge des Medikaments.


                                      The amount of medication administered.

                                      ShortMenge des verabreichten MedikamentsAmount of medication administered
                                      Comments

                                      Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                      Control0..1*
                                      This element is affected by the following invariants: ele-1
                                      TypeElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      366. MedicationRequest.dosageInstruction.doseAndRate.type
                                      Definition

                                      The kind of dose or rate specified, for example, ordered or calculated.

                                      ShortThe kind of dose or rate specified
                                      Comments

                                      Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                      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..01
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1
                                      (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                                      The kind of dose or rate specified.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      If the type is not populated, assume to be "ordered".

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      368. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                                      Definition

                                      The comparator is not used on a SimpleQuantity


                                      Amount of medication per dose.

                                      ShortA fixed quantity (no comparator)Amount of medication per dose
                                      Comments

                                      Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                      Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeQuantity(SimpleQuantity, SimpleQuantity), Range
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      The amount of therapeutic or other substance given at one administration event.

                                      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())
                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                      • type @ $this
                                      • 370. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity
                                        Slice NamedoseQuantity
                                        Definition

                                        Menge des Medikaments pro Dosis.


                                        Amount of medication per dose.

                                        ShortMenge des Medikaments pro DosisAmount of medication per dose
                                        Comments

                                        Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.


                                        Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        BindingThe codes SHALL be taken from For codes, see https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
                                        (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                                        TypeQuantity(SimpleQuantity, SimpleQuantity), Range
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        The amount of therapeutic or other substance given at one administration event.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        372. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
                                        Definition

                                        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                        ShortNumerical value (with implicit precision)
                                        Comments

                                        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

                                        Precision is handled implicitly in almost all cases of measurement.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        374. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator
                                        Definition

                                        Not allowed to be used in this context


                                        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                        Short< | <= | >= | > - how to understand the value
                                        Control0..01
                                        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                        How the Quantity should be understood and represented.

                                        Typecode
                                        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        376. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit
                                        Definition

                                        A human-readable form of the unit.

                                        ShortUnit representation
                                        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

                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        378. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system
                                        Definition

                                        The identification of the system that provides the coded form of the unit.

                                        ShortSystem that defines coded unit form
                                        Comments

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

                                        Control10..1
                                        This element is affected by the following invariants: qty-3
                                        Typeuri
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to know the system that defines the coded form of the unit.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        380. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code
                                        Definition

                                        A computer processable form of the unit in some unit representation system.

                                        ShortCoded form of the unit
                                        Comments

                                        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular 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 a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        382. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
                                        Definition

                                        Amount of medication per unit of time.

                                        ShortAmount of medication per unit of time
                                        Comments

                                        Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                        It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                        It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                        Control0..01
                                        This element is affected by the following invariants: ele-1
                                        TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

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

                                        Upper limit on medication per unit of time.

                                        ShortUpper limit on medication per unit of time
                                        Comments

                                        Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                        This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                        Control0..01
                                        This element is affected by the following invariants: ele-1
                                        TypeRatio
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                        386. MedicationRequest.dosageInstruction.maxDosePerAdministration
                                        Definition

                                        Upper limit on medication per administration.

                                        ShortUpper limit on medication per administration
                                        Comments

                                        Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                        This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                                        Control0..01
                                        This element is affected by the following invariants: ele-1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                        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())
                                        388. MedicationRequest.dosageInstruction.maxDosePerLifetime
                                        Definition

                                        Upper limit on medication per lifetime of the patient.

                                        ShortUpper limit on medication per lifetime of the patient
                                        Comments

                                        Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                                        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..01
                                        This element is affected by the following invariants: ele-1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                        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())
                                        390. 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
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        392. 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..*
                                        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 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())
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        394. 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
                                        Must Supporttrue
                                        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())
                                        396. MedicationRequest.dispenseRequest.quantity.value
                                        Definition

                                        Number of Prescribed Packages


                                        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                        ShortNumber of Prescribed PackagesNumerical value (with implicit precision)
                                        Comments

                                        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

                                        Precision is handled implicitly in almost all cases of measurement.

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

                                        Not allowed to be used in this context


                                        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                        Short< | <= | >= | > - how to understand the value
                                        Control0..01
                                        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                        How the Quantity should be understood and represented.

                                        Typecode
                                        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        400. MedicationRequest.dispenseRequest.quantity.unit
                                        Definition

                                        A human-readable form of the unit.

                                        ShortUnit representation
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

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

                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

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

                                        The identification of the system that provides the coded form of the unit.

                                        ShortSystem that defines coded unit form
                                        Comments

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

                                        Control0..1
                                        This element is affected by the following invariants: qty-3
                                        Typeuri
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to know the system that defines the coded form of the unit.

                                        Pattern Valuehttp://unitsofmeasure.org
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        404. MedicationRequest.dispenseRequest.quantity.code
                                        Definition

                                        A computer processable form of the unit in some unit representation system.

                                        ShortCoded form of the unit
                                        Comments

                                        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

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

                                        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        406. 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
                                        Must Supporttrue
                                        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())
                                        408. 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
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        410. 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..*
                                        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 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())
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        412. 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
                                        Typeboolean, CodeableConcept
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        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:multiplePrescription
                                        Slice NamemultiplePrescription
                                        Control0..1
                                        TypeExtension(MultiplePrescription) (Complex Extension)
                                        Must Supporttrue
                                        10. MedicationRequest.extension:multiplePrescription.extension
                                        Must Supporttrue
                                        12. MedicationRequest.extension:multiplePrescription.extension:indicator
                                        Slice Nameindicator
                                        Must Supporttrue
                                        14. MedicationRequest.extension:multiplePrescription.extension:indicator.url
                                        Must Supporttrue
                                        16. MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        18. MedicationRequest.extension:multiplePrescription.extension:counter
                                        Slice Namecounter
                                        Must Supporttrue
                                        20. MedicationRequest.extension:multiplePrescription.extension:counter.url
                                        Must Supporttrue
                                        22. MedicationRequest.extension:multiplePrescription.extension:counter.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        24. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator
                                        Must Supporttrue
                                        26. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value
                                        Must Supporttrue
                                        28. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator
                                        Must Supporttrue
                                        30. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value
                                        Must Supporttrue
                                        32. MedicationRequest.extension:multiplePrescription.extension:period
                                        Slice Nameperiod
                                        Must Supporttrue
                                        34. MedicationRequest.extension:multiplePrescription.extension:period.url
                                        Must Supporttrue
                                        36. MedicationRequest.extension:multiplePrescription.extension:period.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        38. MedicationRequest.extension:multiplePrescription.extension:period.value[x].start
                                        Must Supporttrue
                                        40. MedicationRequest.extension:multiplePrescription.extension:period.value[x].end
                                        Must Supporttrue
                                        42. MedicationRequest.extension:multiplePrescription.extension:id
                                        Slice Nameid
                                        Must Supporttrue
                                        44. MedicationRequest.extension:multiplePrescription.extension:id.url
                                        Must Supporttrue
                                        46. MedicationRequest.extension:multiplePrescription.extension:id.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        48. MedicationRequest.extension:multiplePrescription.extension:id.value[x].system
                                        Must Supporttrue
                                        50. MedicationRequest.extension:multiplePrescription.extension:id.value[x].value
                                        Must Supporttrue
                                        52. MedicationRequest.extension:multiplePrescription.url
                                        Must Supporttrue
                                        54. MedicationRequest.extension:isBvg
                                        Slice NameisBvg
                                        Control0..1
                                        TypeExtension(IndicatorBVGExtension) (Extension Type: boolean)
                                        Must Supporttrue
                                        56. MedicationRequest.extension:isBvg.url
                                        Must Supporttrue
                                        58. MedicationRequest.extension:isBvg.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        60. MedicationRequest.extension:isSer
                                        Slice NameisSer
                                        Control0..1
                                        TypeExtension(IndicatorSERExtension) (Extension Type: boolean)
                                        Must Supporttrue
                                        62. MedicationRequest.extension:isSer.url
                                        Must Supporttrue
                                        64. MedicationRequest.extension:isSer.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        66. MedicationRequest.extension:prescriberID
                                        Slice NameprescriberID
                                        Control0..1
                                        TypeExtension(PrescriberIDExtension) (Extension Type: Identifier)
                                        68. MedicationRequest.extension:prescriberID.url
                                        Must Supporttrue
                                        70. MedicationRequest.extension:prescriberID.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        72. MedicationRequest.extension:prescriberID.value[x].type
                                        Must Supporttrue
                                        74. MedicationRequest.extension:prescriberID.value[x].type.coding
                                        Must Supporttrue
                                        76. MedicationRequest.extension:prescriberID.value[x].type.coding.system
                                        Must Supporttrue
                                        78. MedicationRequest.extension:prescriberID.value[x].type.coding.version
                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        Must Supporttrue
                                        80. MedicationRequest.extension:prescriberID.value[x].type.coding.code
                                        Must Supporttrue
                                        82. MedicationRequest.extension:prescriberID.value[x].type.coding.display
                                        Must Supporttrue
                                        84. MedicationRequest.extension:prescriberID.value[x].system
                                        Must Supporttrue
                                        86. MedicationRequest.extension:prescriberID.value[x].value
                                        Must Supporttrue
                                        88. MedicationRequest.extension:patientID
                                        Slice NamepatientID
                                        Control0..1
                                        TypeExtension(PatientIDExtension) (Extension Type: Identifier)
                                        90. MedicationRequest.extension:patientID.url
                                        Must Supporttrue
                                        92. MedicationRequest.extension:patientID.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        94. MedicationRequest.extension:patientID.value[x].type
                                        Must Supporttrue
                                        96. MedicationRequest.extension:patientID.value[x].type.coding
                                        Must Supporttrue
                                        98. MedicationRequest.extension:patientID.value[x].type.coding.system
                                        Must Supporttrue
                                        100. MedicationRequest.extension:patientID.value[x].type.coding.version
                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        Must Supporttrue
                                        102. MedicationRequest.extension:patientID.value[x].type.coding.code
                                        Must Supporttrue
                                        104. MedicationRequest.extension:patientID.value[x].type.coding.display
                                        Must Supporttrue
                                        106. MedicationRequest.extension:patientID.value[x].system
                                        Must Supporttrue
                                        108. MedicationRequest.extension:patientID.value[x].value
                                        Must Supporttrue
                                        110. MedicationRequest.extension:narcotics
                                        Slice Namenarcotics
                                        Definition

                                        Abbildung der Angaben zur Verordnung eines Betäubungsmittels im Sinne des Betäubungsmittelgesetzes (BtMG)

                                        ShortBetäubungsmittel (BtM)
                                        Control0..1
                                        TypeExtension(NarcoticsExtension) (Complex Extension)
                                        Must Supporttrue
                                        112. MedicationRequest.extension:teratogenic
                                        Slice Nameteratogenic
                                        Definition

                                        Abbildung der Angaben zur Verordnung eines teratogenen Arzneimittels (T-Rezept)

                                        ShortT-Rezept
                                        Control0..1
                                        TypeExtension(TeratogenicExtension) (Complex Extension)
                                        Must Supporttrue
                                        114. 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
                                        116. MedicationRequest.extension:renderedDosageInstruction.url
                                        Must Supporttrue
                                        118. MedicationRequest.extension:renderedDosageInstruction.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        120. 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
                                        122. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language
                                        Slice Namelanguage
                                        124. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.url
                                        Must Supporttrue
                                        126. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion
                                        Slice NamealgorithmVersion
                                        128. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.url
                                        Must Supporttrue
                                        130. MedicationRequest.extension:generatedDosageInstructionsMeta.url
                                        Must Supporttrue
                                        132. 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:
                                        • pattern @ $this
                                        • 134. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
                                          Slice NameRxPrescriptionProcessIdentifier
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..1
                                          TypeIdentifier(RxPrescriptionProcessIdentifier)
                                          Pattern Value{
                                            "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"
                                          }
                                          136. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type
                                          Must Supporttrue
                                          138. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding
                                          Must Supporttrue
                                          140. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.system
                                          Must Supporttrue
                                          142. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.version
                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Must Supporttrue
                                          144. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.code
                                          Must Supporttrue
                                          146. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.display
                                          Must Supporttrue
                                          148. MedicationRequest.identifier:RxOriginatorProcessIdentifier
                                          Slice NameRxOriginatorProcessIdentifier
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..1
                                          TypeIdentifier(RxOriginatorProcessIdentifier)
                                          Pattern Value{
                                            "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
                                          }
                                          150. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type
                                          Must Supporttrue
                                          152. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding
                                          Must Supporttrue
                                          154. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.system
                                          Must Supporttrue
                                          156. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.version
                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Must Supporttrue
                                          158. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.code
                                          Must Supporttrue
                                          160. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.display
                                          Must Supporttrue
                                          162. MedicationRequest.status
                                          ShortStatus of Medication Request
                                          BindingThe codes SHALL be taken from TI Medication Request ValueSet
                                          (required to https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs)
                                          Must Supporttrue
                                          164. MedicationRequest.intent
                                          Definition

                                          e.g. when data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.

                                          Shortfiller-order
                                          Must Supporttrue
                                          166. MedicationRequest.medication[x]
                                          TypeReference(Medication), CodeableConcept
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Must Supporttrue
                                          168. MedicationRequest.medication[x].reference
                                          Must Supporttrue
                                          170. MedicationRequest.medication[x].identifier
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Must Supporttrue
                                          172. MedicationRequest.medication[x].identifier.type
                                          Must Supporttrue
                                          174. MedicationRequest.medication[x].identifier.type.coding
                                          Must Supporttrue
                                          176. MedicationRequest.medication[x].identifier.type.coding.system
                                          Must Supporttrue
                                          178. MedicationRequest.medication[x].identifier.type.coding.version
                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Must Supporttrue
                                          180. MedicationRequest.medication[x].identifier.type.coding.code
                                          Must Supporttrue
                                          182. MedicationRequest.medication[x].identifier.type.coding.display
                                          Must Supporttrue
                                          184. MedicationRequest.medication[x].identifier.system
                                          Must Supporttrue
                                          186. MedicationRequest.medication[x].identifier.value
                                          Must Supporttrue
                                          188. MedicationRequest.medication[x].display
                                          Must Supporttrue
                                          190. MedicationRequest.subject
                                          TypeReference(Patient)
                                          Must Supporttrue
                                          192. 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
                                          194. MedicationRequest.authoredOn
                                          Definition

                                          Issue Date of the Prescription

                                          ShortIssue Date
                                          Control1..?
                                          Must Supporttrue
                                          196. MedicationRequest.requester
                                          TypeReference(Organization, Practitioner, PractitionerRole)
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          198. MedicationRequest.requester.reference
                                          Must Supporttrue
                                          200. MedicationRequest.requester.identifier
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Must Supporttrue
                                          202. MedicationRequest.requester.identifier.type
                                          Must Supporttrue
                                          204. MedicationRequest.requester.identifier.type.coding
                                          Must Supporttrue
                                          206. MedicationRequest.requester.identifier.type.coding.system
                                          Must Supporttrue
                                          208. MedicationRequest.requester.identifier.type.coding.version
                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Must Supporttrue
                                          210. MedicationRequest.requester.identifier.type.coding.code
                                          Must Supporttrue
                                          212. MedicationRequest.requester.identifier.type.coding.display
                                          Must Supporttrue
                                          214. MedicationRequest.requester.identifier.system
                                          Must Supporttrue
                                          216. MedicationRequest.requester.identifier.value
                                          Must Supporttrue
                                          218. MedicationRequest.requester.display
                                          Must Supporttrue
                                          220. MedicationRequest.basedOn
                                          TypeReference(eMP MedicationRequest)
                                          Must Supporttrue
                                          222. MedicationRequest.basedOn.reference
                                          Must Supporttrue
                                          224. MedicationRequest.basedOn.identifier
                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          TypeIdentifier(Profil für den Identifikator eines eMP-Eintrags)
                                          Must Supporttrue
                                          226. MedicationRequest.basedOn.identifier.type
                                          Must Supporttrue
                                          228. MedicationRequest.basedOn.identifier.type.coding
                                          Must Supporttrue
                                          230. MedicationRequest.basedOn.identifier.type.coding.system
                                          Must Supporttrue
                                          232. MedicationRequest.basedOn.identifier.type.coding.version
                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Must Supporttrue
                                          234. MedicationRequest.basedOn.identifier.type.coding.code
                                          Must Supporttrue
                                          236. MedicationRequest.basedOn.identifier.type.coding.display
                                          Must Supporttrue
                                          238. MedicationRequest.basedOn.identifier.system
                                          Must Supporttrue
                                          240. MedicationRequest.basedOn.identifier.value
                                          Must Supporttrue
                                          242. MedicationRequest.basedOn.display
                                          Must Supporttrue
                                          244. MedicationRequest.note
                                          Control0..1
                                          Must Supporttrue
                                          246. MedicationRequest.note.text
                                          Definition

                                          Instructions to the pharmacy that go beyond the dosage information

                                          ShortDispensing Note
                                          Must Supporttrue
                                          248. MedicationRequest.dosageInstruction
                                          Definition

                                          Hier werden Informationen zur Dosierung angegeben.

                                          ShortHier werden Informationen zur Dosierung angegeben.
                                          TypeDosage(Dosage dgMP)
                                          Must Supporttrue
                                          250. MedicationRequest.dosageInstruction.doseAndRate
                                          252. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Must Supporttrue
                                          254. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity
                                          Slice NamedoseQuantity
                                          TypeQuantity(SimpleQuantity)
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          256. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
                                          Must Supporttrue
                                          258. MedicationRequest.dispenseRequest
                                          Must Supporttrue
                                          260. MedicationRequest.dispenseRequest.quantity
                                          Must Supporttrue
                                          262. MedicationRequest.dispenseRequest.quantity.value
                                          Definition

                                          Number of Prescribed Packages

                                          ShortNumber of Prescribed Packages
                                          Control1..?
                                          Must Supporttrue
                                          264. MedicationRequest.dispenseRequest.quantity.unit
                                          Must Supporttrue
                                          266. MedicationRequest.dispenseRequest.quantity.system
                                          Must Supporttrue
                                          Pattern Valuehttp://unitsofmeasure.org
                                          268. MedicationRequest.dispenseRequest.quantity.code
                                          Must Supporttrue
                                          270. MedicationRequest.dispenseRequest.expectedSupplyDuration
                                          Must Supporttrue
                                          272. MedicationRequest.substitution
                                          Must Supporttrue
                                          274. MedicationRequest.substitution.allowed[x]
                                          Typeboolean, CodeableConcept
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue

                                          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

                                            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.

                                            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. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 32. MedicationRequest.extension:multiplePrescription
                                              Slice NamemultiplePrescription
                                              Definition

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

                                              ShortMultiplePrescription
                                              Control0..1
                                              TypeExtension(MultiplePrescription) (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())
                                              34. MedicationRequest.extension:multiplePrescription.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:multiplePrescription.extension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..*
                                              TypeExtension
                                              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())
                                              SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 38. MedicationRequest.extension:multiplePrescription.extension:indicator
                                                Slice Nameindicator
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..1
                                                TypeExtension
                                                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())
                                                40. MedicationRequest.extension:multiplePrescription.extension:indicator.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
                                                42. MedicationRequest.extension:multiplePrescription.extension:indicator.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..0
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 44. MedicationRequest.extension:multiplePrescription.extension:indicator.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
                                                  Must Supporttrue
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Fixed Valueindicator
                                                  46. MedicationRequest.extension:multiplePrescription.extension:indicator.value[x]
                                                  Definition

                                                  Indicator of whether the current prescription is part of a multiple prescription

                                                  true - the current prescription is part of a multiple prescription false - the current prescription is not part of a multiple prescription

                                                  ShortMultiple Prescription Indicator
                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typeboolean
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  48. MedicationRequest.extension:multiplePrescription.extension:counter
                                                  Slice Namecounter
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..1
                                                  TypeExtension
                                                  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:multiplePrescription.extension:counter.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:multiplePrescription.extension:counter.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..0
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 54. MedicationRequest.extension:multiplePrescription.extension:counter.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
                                                    Must Supporttrue
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Fixed Valuecounter
                                                    56. MedicationRequest.extension:multiplePrescription.extension:counter.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
                                                    TypeRatio
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    58. MedicationRequest.extension:multiplePrescription.extension:counter.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:multiplePrescription.extension:counter.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.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 62. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator
                                                      Definition

                                                      The value of the numerator.

                                                      ShortNumerator value
                                                      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.

                                                      Control1..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeQuantity
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      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())
                                                      64. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.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
                                                      66. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.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.extension.value[x].numerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 68. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.value
                                                        Definition

                                                        The field serves to indicate which number in a series of multiple prescriptions it is. Example: "2" in "2 out of 4"

                                                        ShortMultiple Prescription Counter
                                                        Comments

                                                        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

                                                        Precision is handled implicitly in almost all cases of measurement.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        70. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.comparator
                                                        Definition

                                                        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                        Short< | <= | >= | > - how to understand the value
                                                        Control0..0
                                                        BindingThe codes SHALL be taken from QuantityComparator
                                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                        How the Quantity should be understood and represented.

                                                        Typecode
                                                        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        72. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.unit
                                                        Definition

                                                        A human-readable form of the unit.

                                                        ShortUnit representation
                                                        Comments

                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                        Control0..0
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        74. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.system
                                                        Definition

                                                        The identification of the system that provides the coded form of the unit.

                                                        ShortSystem that defines coded unit form
                                                        Comments

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

                                                        Control0..0
                                                        This element is affected by the following invariants: qty-3
                                                        Typeuri
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Need to know the system that defines the coded form of the unit.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        76. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].numerator.code
                                                        Definition

                                                        A computer processable form of the unit in some unit representation system.

                                                        ShortCoded form of the unit
                                                        Comments

                                                        The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                        Control0..0
                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        78. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator
                                                        Definition

                                                        The value of the denominator.

                                                        ShortDenominator value
                                                        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.

                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeQuantity
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summarytrue
                                                        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())
                                                        80. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.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
                                                        82. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.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.extension.value[x].denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 84. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.value
                                                          Definition

                                                          The field serves to indicate the length of this series. Example: "4" in "2 out of 4"

                                                          ShortDenominator of Multiple Prescription Series
                                                          Comments

                                                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

                                                          Precision is handled implicitly in almost all cases of measurement.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          86. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.comparator
                                                          Definition

                                                          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                          Short< | <= | >= | > - how to understand the value
                                                          Control0..0
                                                          BindingThe codes SHALL be taken from QuantityComparator
                                                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                          How the Quantity should be understood and represented.

                                                          Typecode
                                                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          88. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.unit
                                                          Definition

                                                          A human-readable form of the unit.

                                                          ShortUnit representation
                                                          Comments

                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                          Control0..0
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          90. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.system
                                                          Definition

                                                          The identification of the system that provides the coded form of the unit.

                                                          ShortSystem that defines coded unit form
                                                          Comments

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

                                                          Control0..0
                                                          This element is affected by the following invariants: qty-3
                                                          Typeuri
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Need to know the system that defines the coded form of the unit.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          92. MedicationRequest.extension:multiplePrescription.extension:counter.value[x].denominator.code
                                                          Definition

                                                          A computer processable form of the unit in some unit representation system.

                                                          ShortCoded form of the unit
                                                          Comments

                                                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                          Control0..0
                                                          Typecode
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          94. MedicationRequest.extension:multiplePrescription.extension:period
                                                          Slice Nameperiod
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..1
                                                          TypeExtension
                                                          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())
                                                          96. MedicationRequest.extension:multiplePrescription.extension:period.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.extension:multiplePrescription.extension:period.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..0
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 100. MedicationRequest.extension:multiplePrescription.extension:period.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
                                                            Must Supporttrue
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed Valueperiod
                                                            102. MedicationRequest.extension:multiplePrescription.extension:period.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
                                                            Must Supporttrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            -limitationDateStart: Limitation of the date format to 10 characters YYYY-MM-DD (start.toString().length()=10)
                                                            -limitationDateEnd: Limitation of the date format to 10 characters YYYY-MM-DD (end.exists().not() or end.toString().length()=10)
                                                            104. MedicationRequest.extension:multiplePrescription.extension:period.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
                                                            106. MedicationRequest.extension:multiplePrescription.extension:period.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.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 108. MedicationRequest.extension:multiplePrescription.extension:period.value[x].start
                                                              Definition

                                                              Date from which the partial prescription of the multiple prescription can be redeemed

                                                              ShortStart Date of the Prescription Redemption Period
                                                              Comments

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

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

                                                              Date of the last redemption day for the partial prescription within the multiple prescription series. The issuer may specify a redemption period different from the one outlined in the Medicinal Products Prescription Ordinance (AMVV)

                                                              ShortEnd Date of the Prescription Redemption Period
                                                              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
                                                              Must Supporttrue
                                                              Summarytrue
                                                              Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              112. MedicationRequest.extension:multiplePrescription.extension:id
                                                              Slice Nameid
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..1
                                                              TypeExtension
                                                              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())
                                                              114. MedicationRequest.extension:multiplePrescription.extension:id.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
                                                              116. MedicationRequest.extension:multiplePrescription.extension:id.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..0
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 118. MedicationRequest.extension:multiplePrescription.extension:id.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
                                                                Must Supporttrue
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Fixed Valueid
                                                                120. MedicationRequest.extension:multiplePrescription.extension:id.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
                                                                TypeIdentifier
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                122. MedicationRequest.extension:multiplePrescription.extension:id.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
                                                                124. MedicationRequest.extension:multiplePrescription.extension:id.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.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 126. MedicationRequest.extension:multiplePrescription.extension:id.value[x].use
                                                                  Definition

                                                                  The purpose of this identifier.

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

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

                                                                  Control0..0
                                                                  BindingThe codes SHALL be taken from IdentifierUse
                                                                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                  Identifies the purpose for this identifier, if known .

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

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

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  128. MedicationRequest.extension:multiplePrescription.extension:id.value[x].type
                                                                  Definition

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

                                                                  ShortDescription of identifier
                                                                  Comments

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

                                                                  Control0..0
                                                                  This element is affected by the following invariants: ele-1
                                                                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Requirements

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

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  130. MedicationRequest.extension:multiplePrescription.extension:id.value[x].system
                                                                  Definition

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

                                                                  ShortSpecification as UUID
                                                                  Comments

                                                                  Identifier.system is always case sensitive.

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

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

                                                                  Fixed Valueurn:ietf:rfc:3986
                                                                  ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  132. MedicationRequest.extension:multiplePrescription.extension:id.value[x].value
                                                                  Definition

                                                                  A unique ID that is identical across all partial prescriptions of a multiple prescription.

                                                                  ShortMultiple Prescription ID
                                                                  Comments

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

                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  ExampleGeneral: 123456
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  134. MedicationRequest.extension:multiplePrescription.extension:id.value[x].period
                                                                  Definition

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

                                                                  ShortTime period when id is/was valid for use
                                                                  Comments

                                                                  A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                  Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                  Control0..0
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypePeriod
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  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))
                                                                  136. MedicationRequest.extension:multiplePrescription.extension:id.value[x].assigner
                                                                  Definition

                                                                  Organization that issued/manages the identifier.

                                                                  ShortOrganization that issued id (may be just text)
                                                                  Comments

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

                                                                  Control0..0
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeReference(Organization)
                                                                  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')))
                                                                  138. MedicationRequest.extension:multiplePrescription.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
                                                                  Must Supporttrue
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
                                                                  140. MedicationRequest.extension:multiplePrescription.value[x]
                                                                  Definition

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

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

                                                                  Indicator of whether this regulation is made in reference to the 'Bundesentschädigungsgesetz' or the 'Bundesversorgungsgesetz'.

                                                                  ShortExtension
                                                                  Control0..1
                                                                  TypeExtension(IndicatorBVGExtension) (Extension Type: boolean)
                                                                  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())
                                                                  144. MedicationRequest.extension:isBvg.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
                                                                  146. MedicationRequest.extension:isBvg.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
                                                                  • 148. MedicationRequest.extension:isBvg.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
                                                                    Must Supporttrue
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/indicator-bvg-extension
                                                                    150. MedicationRequest.extension:isBvg.value[x]
                                                                    Definition

                                                                    Indicator of whether this regulation applies to claimants under the 'Bundesentschädigungsgesetz' (BEG) or to claimants under the 'Bundesversorgungsgesetz' (BVG).

                                                                    false - not BVG (default value)

                                                                    true - BVG

                                                                    ShortBVG
                                                                    Control1..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typeboolean
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    152. MedicationRequest.extension:isSer
                                                                    Slice NameisSer
                                                                    Definition

                                                                    Kennzeichnung, ob diese Verordnung mit Bezug zum Sozialen Entschädigungsrecht nach SGB XIV (SER) erfolgt

                                                                    ShortExtension
                                                                    Control0..1
                                                                    TypeExtension(IndicatorSERExtension) (Extension Type: boolean)
                                                                    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())
                                                                    154. MedicationRequest.extension:isSer.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
                                                                    156. MedicationRequest.extension:isSer.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
                                                                    • 158. MedicationRequest.extension:isSer.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
                                                                      Must Supporttrue
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/indicator-ser-extension
                                                                      160. MedicationRequest.extension:isSer.value[x]
                                                                      Definition

                                                                      Kennzeichnung, ob diese Verordnung mit Bezug zum Sozialen Entschädigungsrecht nach SGB XIV (SER) erfolgt

                                                                      false - not SER (default value)

                                                                      true - SER

                                                                      ShortSER
                                                                      Control1..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      Typeboolean
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      162. MedicationRequest.extension:prescriberID
                                                                      Slice NameprescriberID
                                                                      Definition

                                                                      Verschreiber-ID, welche bei der Verordnung bestimmter Präparate anzugeben ist, damit die Apotheke das Rezept beliefern darf.

                                                                      ShortExtension
                                                                      Control0..1
                                                                      TypeExtension(PrescriberIDExtension) (Extension Type: Identifier)
                                                                      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())
                                                                      164. MedicationRequest.extension:prescriberID.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
                                                                      166. MedicationRequest.extension:prescriberID.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
                                                                      • 168. MedicationRequest.extension:prescriberID.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
                                                                        Must Supporttrue
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/prescriber-id-extension
                                                                        170. MedicationRequest.extension:prescriberID.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
                                                                        TypeIdentifier
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        172. MedicationRequest.extension:prescriberID.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
                                                                        174. MedicationRequest.extension:prescriberID.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
                                                                        • 176. MedicationRequest.extension:prescriberID.value[x].use
                                                                          Definition

                                                                          The purpose of this identifier.

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

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

                                                                          Control0..0
                                                                          BindingThe codes SHALL be taken from IdentifierUse
                                                                          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                          Identifies the purpose for this identifier, if known .

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

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

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          178. MedicationRequest.extension:prescriberID.value[x].type
                                                                          Definition

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

                                                                          ShortDescription of identifier
                                                                          Comments

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

                                                                          Control0..0
                                                                          This element is affected by the following invariants: ele-1
                                                                          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                          (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Requirements

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

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          191. MedicationRequest.extension:prescriberID.value[x].system
                                                                          Definition

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

                                                                          ShortThe namespace for the identifier value
                                                                          Comments

                                                                          Identifier.system is always case sensitive.

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

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

                                                                          ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          193. MedicationRequest.extension:prescriberID.value[x].value
                                                                          Definition

                                                                          Verschreiber-ID, welche bei der Verordnung bestimmter Präparate anzugeben ist, damit die Apotheke das Rezept beliefern darf.

                                                                          ShortVerschreiber-ID
                                                                          Comments

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

                                                                          Control1..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          ExampleGeneral: 123456
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          195. MedicationRequest.extension:prescriberID.value[x].period
                                                                          Definition

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

                                                                          ShortTime period when id is/was valid for use
                                                                          Comments

                                                                          A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                          Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                          Control0..0
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypePeriod
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          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))
                                                                          197. MedicationRequest.extension:prescriberID.value[x].assigner
                                                                          Definition

                                                                          Organization that issued/manages the identifier.

                                                                          ShortOrganization that issued id (may be just text)
                                                                          Comments

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

                                                                          Control0..0
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeReference(Organization)
                                                                          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')))
                                                                          199. MedicationRequest.extension:patientID
                                                                          Slice NamepatientID
                                                                          Definition

                                                                          Patienten-ID, welche bei der Verordnung bestimmter Arzneimittel angegeben werden kann.

                                                                          ShortExtension
                                                                          Control0..1
                                                                          TypeExtension(PatientIDExtension) (Extension Type: Identifier)
                                                                          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())
                                                                          201. MedicationRequest.extension:patientID.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
                                                                          203. MedicationRequest.extension:patientID.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
                                                                          • 205. MedicationRequest.extension:patientID.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
                                                                            Must Supporttrue
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/patient-id-extension
                                                                            207. MedicationRequest.extension:patientID.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
                                                                            TypeIdentifier
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            209. MedicationRequest.extension:patientID.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
                                                                            211. MedicationRequest.extension:patientID.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
                                                                            • 213. MedicationRequest.extension:patientID.value[x].use
                                                                              Definition

                                                                              The purpose of this identifier.

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

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

                                                                              Control0..0
                                                                              BindingThe codes SHALL be taken from IdentifierUse
                                                                              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                              Identifies the purpose for this identifier, if known .

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

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

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              215. MedicationRequest.extension:patientID.value[x].type
                                                                              Definition

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

                                                                              ShortDescription of identifier
                                                                              Comments

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

                                                                              Control0..0
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                              (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Requirements

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

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              228. MedicationRequest.extension:patientID.value[x].system
                                                                              Definition

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

                                                                              ShortThe namespace for the identifier value
                                                                              Comments

                                                                              Identifier.system is always case sensitive.

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

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

                                                                              ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              230. MedicationRequest.extension:patientID.value[x].value
                                                                              Definition

                                                                              Patienten-ID, welche bei der Verordnung bestimmter Arzneimittel angegeben werden kann.

                                                                              ShortPatienten-ID
                                                                              Comments

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

                                                                              Control1..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              ExampleGeneral: 123456
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              232. MedicationRequest.extension:patientID.value[x].period
                                                                              Definition

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

                                                                              ShortTime period when id is/was valid for use
                                                                              Comments

                                                                              A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                              Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                              Control0..0
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypePeriod
                                                                              Is Modifierfalse
                                                                              Summarytrue
                                                                              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))
                                                                              234. MedicationRequest.extension:patientID.value[x].assigner
                                                                              Definition

                                                                              Organization that issued/manages the identifier.

                                                                              ShortOrganization that issued id (may be just text)
                                                                              Comments

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

                                                                              Control0..0
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeReference(Organization)
                                                                              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')))
                                                                              236. MedicationRequest.extension:narcotics
                                                                              Slice Namenarcotics
                                                                              Definition

                                                                              Abbildung der Angaben zur Verordnung eines Betäubungsmittels im Sinne des Betäubungsmittelgesetzes (BtMG)

                                                                              ShortBetäubungsmittel (BtM)
                                                                              Control0..1
                                                                              TypeExtension(NarcoticsExtension) (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())
                                                                              238. MedicationRequest.extension:teratogenic
                                                                              Slice Nameteratogenic
                                                                              Definition

                                                                              Abbildung der Angaben zur Verordnung eines teratogenen Arzneimittels (T-Rezept)

                                                                              ShortT-Rezept
                                                                              Control0..1
                                                                              TypeExtension(TeratogenicExtension) (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())
                                                                              240. 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())
                                                                              242. MedicationRequest.extension:renderedDosageInstruction.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
                                                                              244. MedicationRequest.extension:renderedDosageInstruction.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
                                                                              • 246. MedicationRequest.extension:renderedDosageInstruction.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
                                                                                Must Supporttrue
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
                                                                                248. MedicationRequest.extension:renderedDosageInstruction.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
                                                                                Typemarkdown
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                250. 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())
                                                                                252. MedicationRequest.extension:generatedDosageInstructionsMeta.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
                                                                                254. MedicationRequest.extension:generatedDosageInstructionsMeta.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.

                                                                                Control2..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 256. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language
                                                                                  Slice Namelanguage
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control1..1
                                                                                  TypeExtension
                                                                                  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())
                                                                                  258. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.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
                                                                                  260. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.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..0
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 262. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.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
                                                                                    Must Supporttrue
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Fixed Valuelanguage
                                                                                    264. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.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
                                                                                    TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                                    [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()))
                                                                                    SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • type @ $this
                                                                                    • 266. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:language.value[x]:valueCode
                                                                                      Slice NamevalueCode
                                                                                      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
                                                                                      BindingThe codes SHALL be taken from AllLanguages
                                                                                      (required to http://hl7.org/fhir/ValueSet/all-languages)
                                                                                      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
                                                                                      Must Supporttrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      268. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion
                                                                                      Slice NamealgorithmVersion
                                                                                      Definition

                                                                                      An Extension

                                                                                      ShortExtension
                                                                                      Control1..1
                                                                                      TypeExtension
                                                                                      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())
                                                                                      270. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.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
                                                                                      272. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.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..0
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 274. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.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
                                                                                        Must Supporttrue
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Fixed ValuealgorithmVersion
                                                                                        276. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.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
                                                                                        TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                                        [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()))
                                                                                        SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • type @ $this
                                                                                        • 278. MedicationRequest.extension:generatedDosageInstructionsMeta.extension:algorithmVersion.value[x]:valueString
                                                                                          Slice NamevalueString
                                                                                          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
                                                                                          Typestring
                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          280. MedicationRequest.extension:generatedDosageInstructionsMeta.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
                                                                                          Must Supporttrue
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          Fixed Valuehttp://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta
                                                                                          282. MedicationRequest.extension:generatedDosageInstructionsMeta.value[x]
                                                                                          Definition

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

                                                                                          ShortValue of extension
                                                                                          Control0..0
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          284. 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
                                                                                          • 286. 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:
                                                                                            • pattern @ $this
                                                                                            • 288. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
                                                                                              Slice NameRxPrescriptionProcessIdentifier
                                                                                              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(RxPrescriptionProcessIdentifier)
                                                                                              Is Modifierfalse
                                                                                              Pattern Value{
                                                                                                "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"
                                                                                              }
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              290. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.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
                                                                                              292. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.extension
                                                                                              Definition

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

                                                                                              ShortAdditional content defined by implementations
                                                                                              Comments

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

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

                                                                                                The purpose of this identifier.

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

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

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

                                                                                                Identifies the purpose for this identifier, if known .

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

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

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

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

                                                                                                ShortDescription of identifier
                                                                                                Comments

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

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

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

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                298. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.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
                                                                                                300. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.extension
                                                                                                Definition

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

                                                                                                ShortAdditional content defined by implementations
                                                                                                Comments

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

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

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

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

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

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

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

                                                                                                    ShortIdentity 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.

                                                                                                    Control0..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.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    310. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.version
                                                                                                    Definition

                                                                                                    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.

                                                                                                    ShortVersion 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)
                                                                                                    Control0..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()))
                                                                                                    312. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.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).

                                                                                                    ShortSymbol in syntax defined by the system
                                                                                                    Control0..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.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    314. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.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

                                                                                                    Control0..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()))
                                                                                                    316. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.coding.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()))
                                                                                                    318. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.type.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()))
                                                                                                    320. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.system
                                                                                                    Definition

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

                                                                                                    ShortThe namespace for the identifier value
                                                                                                    Comments

                                                                                                    Identifier.system is always case sensitive.

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

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

                                                                                                    Pattern Valuehttps://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier
                                                                                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    322. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.value
                                                                                                    Definition

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

                                                                                                    ShortThe value that is unique
                                                                                                    Comments

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

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    ExampleGeneral: 123456
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    324. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.period
                                                                                                    Definition

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

                                                                                                    ShortTime period when id is/was valid for use
                                                                                                    Comments

                                                                                                    A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                                    Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypePeriod
                                                                                                    Is Modifierfalse
                                                                                                    Summarytrue
                                                                                                    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))
                                                                                                    326. MedicationRequest.identifier:RxPrescriptionProcessIdentifier.assigner
                                                                                                    Definition

                                                                                                    Organization that issued/manages the identifier.

                                                                                                    ShortOrganization that issued id (may be just text)
                                                                                                    Comments

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

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeReference(Organization)
                                                                                                    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')))
                                                                                                    328. MedicationRequest.identifier:RxOriginatorProcessIdentifier
                                                                                                    Slice NameRxOriginatorProcessIdentifier
                                                                                                    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(RxOriginatorProcessIdentifier)
                                                                                                    Is Modifierfalse
                                                                                                    Pattern Value{
                                                                                                      "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    330. MedicationRequest.identifier:RxOriginatorProcessIdentifier.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
                                                                                                    332. MedicationRequest.identifier:RxOriginatorProcessIdentifier.extension
                                                                                                    Definition

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

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

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

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

                                                                                                      The purpose of this identifier.

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

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

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

                                                                                                      Identifies the purpose for this identifier, if known .

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

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

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

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

                                                                                                      ShortDescription of identifier
                                                                                                      Comments

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

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Must Supporttrue
                                                                                                      Summarytrue
                                                                                                      Requirements

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

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      338. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.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
                                                                                                      340. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.extension
                                                                                                      Definition

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

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

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

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

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

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

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

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

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

                                                                                                          ShortIdentity 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.

                                                                                                          Control0..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.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          350. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.version
                                                                                                          Definition

                                                                                                          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.

                                                                                                          ShortVersion 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)
                                                                                                          Control0..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()))
                                                                                                          352. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.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).

                                                                                                          ShortSymbol in syntax defined by the system
                                                                                                          Control0..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.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          354. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.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

                                                                                                          Control0..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()))
                                                                                                          356. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.coding.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()))
                                                                                                          358. MedicationRequest.identifier:RxOriginatorProcessIdentifier.type.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()))
                                                                                                          360. MedicationRequest.identifier:RxOriginatorProcessIdentifier.system
                                                                                                          Definition

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

                                                                                                          ShortThe namespace for the identifier value
                                                                                                          Comments

                                                                                                          Identifier.system is always case sensitive.

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

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

                                                                                                          Pattern Valuehttps://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
                                                                                                          ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          362. MedicationRequest.identifier:RxOriginatorProcessIdentifier.value
                                                                                                          Definition

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

                                                                                                          ShortThe value that is unique
                                                                                                          Comments

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

                                                                                                          Control1..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          ExampleGeneral: 123456
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          364. MedicationRequest.identifier:RxOriginatorProcessIdentifier.period
                                                                                                          Definition

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

                                                                                                          ShortTime period when id is/was valid for use
                                                                                                          Comments

                                                                                                          A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                                          Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypePeriod
                                                                                                          Is Modifierfalse
                                                                                                          Summarytrue
                                                                                                          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))
                                                                                                          366. MedicationRequest.identifier:RxOriginatorProcessIdentifier.assigner
                                                                                                          Definition

                                                                                                          Organization that issued/manages the identifier.

                                                                                                          ShortOrganization that issued id (may be just text)
                                                                                                          Comments

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

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeReference(Organization)
                                                                                                          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')))
                                                                                                          368. MedicationRequest.status
                                                                                                          Definition

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

                                                                                                          ShortStatus of Medication Request
                                                                                                          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 TI Medication Request ValueSet
                                                                                                          (required to https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-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()))
                                                                                                          370. 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()))
                                                                                                          372. MedicationRequest.intent
                                                                                                          Definition

                                                                                                          e.g. when data is synchronized with the E-Rezept-Fachdienst, the 'filler-order' code should be used here.

                                                                                                          Shortfiller-order
                                                                                                          Comments

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

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

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

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

                                                                                                          The kind of medication order.

                                                                                                          Typecode
                                                                                                          Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          374. 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()))
                                                                                                          376. 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()))
                                                                                                          378. 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()))
                                                                                                          380. 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()))
                                                                                                          382. MedicationRequest.medication[x]
                                                                                                          Definition

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

                                                                                                          ShortMedication to be taken
                                                                                                          Comments

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

                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeReference(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()))
                                                                                                          384. MedicationRequest.medication[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
                                                                                                          386. MedicationRequest.medication[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.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 388. MedicationRequest.medication[x].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
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            390. MedicationRequest.medication[x].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()))
                                                                                                            392. MedicationRequest.medication[x].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)
                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeIdentifier
                                                                                                            Is Modifierfalse
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            394. MedicationRequest.medication[x].identifier.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
                                                                                                            396. MedicationRequest.medication[x].identifier.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.medication[x].identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 398. MedicationRequest.medication[x].identifier.use
                                                                                                              Definition

                                                                                                              The purpose of this identifier.

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

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

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

                                                                                                              Identifies the purpose for this identifier, if known .

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

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

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              400. MedicationRequest.medication[x].identifier.type
                                                                                                              Definition

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

                                                                                                              ShortDescription of identifier
                                                                                                              Comments

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

                                                                                                              Control0..1
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Requirements

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

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              402. MedicationRequest.medication[x].identifier.type.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
                                                                                                              404. MedicationRequest.medication[x].identifier.type.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.medication[x].identifier.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 406. MedicationRequest.medication[x].identifier.type.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()))
                                                                                                                408. MedicationRequest.medication[x].identifier.type.coding.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
                                                                                                                410. MedicationRequest.medication[x].identifier.type.coding.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.medication[x].identifier.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 412. MedicationRequest.medication[x].identifier.type.coding.system
                                                                                                                  Definition

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

                                                                                                                  ShortIdentity 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.

                                                                                                                  Control0..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.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  414. MedicationRequest.medication[x].identifier.type.coding.version
                                                                                                                  Definition

                                                                                                                  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.

                                                                                                                  ShortVersion 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)
                                                                                                                  Control0..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()))
                                                                                                                  416. MedicationRequest.medication[x].identifier.type.coding.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).

                                                                                                                  ShortSymbol in syntax defined by the system
                                                                                                                  Control0..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.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  418. MedicationRequest.medication[x].identifier.type.coding.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

                                                                                                                  Control0..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()))
                                                                                                                  420. MedicationRequest.medication[x].identifier.type.coding.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()))
                                                                                                                  422. MedicationRequest.medication[x].identifier.type.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()))
                                                                                                                  424. MedicationRequest.medication[x].identifier.system
                                                                                                                  Definition

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

                                                                                                                  ShortThe namespace for the identifier value
                                                                                                                  Comments

                                                                                                                  Identifier.system is always case sensitive.

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

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

                                                                                                                  ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  426. MedicationRequest.medication[x].identifier.value
                                                                                                                  Definition

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

                                                                                                                  ShortThe value that is unique
                                                                                                                  Comments

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

                                                                                                                  Control0..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Must Supporttrue
                                                                                                                  Summarytrue
                                                                                                                  ExampleGeneral: 123456
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  428. MedicationRequest.medication[x].identifier.period
                                                                                                                  Definition

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

                                                                                                                  ShortTime period when id is/was valid for use
                                                                                                                  Comments

                                                                                                                  A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                                                  Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                                                  Control0..1
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  TypePeriod
                                                                                                                  Is Modifierfalse
                                                                                                                  Summarytrue
                                                                                                                  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))
                                                                                                                  430. MedicationRequest.medication[x].identifier.assigner
                                                                                                                  Definition

                                                                                                                  Organization that issued/manages the identifier.

                                                                                                                  ShortOrganization that issued id (may be just text)
                                                                                                                  Comments

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

                                                                                                                  Control0..1
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  TypeReference(Organization)
                                                                                                                  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')))
                                                                                                                  432. MedicationRequest.medication[x].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
                                                                                                                  Must Supporttrue
                                                                                                                  Summarytrue
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  434. 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')))
                                                                                                                  436. 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
                                                                                                                  438. 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
                                                                                                                  • 440. 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()))
                                                                                                                    442. 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()))
                                                                                                                    444. 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()))
                                                                                                                    446. 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()))
                                                                                                                    448. 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')))
                                                                                                                    450. 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')))
                                                                                                                    452. MedicationRequest.authoredOn
                                                                                                                    Definition

                                                                                                                    Issue Date of the Prescription

                                                                                                                    ShortIssue Date
                                                                                                                    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()))
                                                                                                                    454. 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(Organization, Practitioner, PractitionerRole)
                                                                                                                    Is Modifierfalse
                                                                                                                    Must Supporttrue
                                                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                    Summarytrue
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    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')))
                                                                                                                    456. MedicationRequest.requester.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
                                                                                                                    458. MedicationRequest.requester.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.requester.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • value @ url
                                                                                                                    • 460. MedicationRequest.requester.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
                                                                                                                      Must Supporttrue
                                                                                                                      Summarytrue
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      462. MedicationRequest.requester.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()))
                                                                                                                      464. MedicationRequest.requester.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)
                                                                                                                      Control0..1
                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                      TypeIdentifier
                                                                                                                      Is Modifierfalse
                                                                                                                      Must Supporttrue
                                                                                                                      Summarytrue
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      466. MedicationRequest.requester.identifier.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
                                                                                                                      468. MedicationRequest.requester.identifier.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.requester.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • value @ url
                                                                                                                      • 470. MedicationRequest.requester.identifier.use
                                                                                                                        Definition

                                                                                                                        The purpose of this identifier.

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

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

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

                                                                                                                        Identifies the purpose for this identifier, if known .

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

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

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

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

                                                                                                                        ShortDescription of identifier
                                                                                                                        Comments

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

                                                                                                                        Control0..1
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

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

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Summarytrue
                                                                                                                        Requirements

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

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        474. MedicationRequest.requester.identifier.type.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
                                                                                                                        476. MedicationRequest.requester.identifier.type.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.requester.identifier.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • value @ url
                                                                                                                        • 478. MedicationRequest.requester.identifier.type.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()))
                                                                                                                          480. MedicationRequest.requester.identifier.type.coding.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
                                                                                                                          482. MedicationRequest.requester.identifier.type.coding.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.requester.identifier.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                          • value @ url
                                                                                                                          • 484. MedicationRequest.requester.identifier.type.coding.system
                                                                                                                            Definition

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

                                                                                                                            ShortIdentity 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.

                                                                                                                            Control0..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.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            486. MedicationRequest.requester.identifier.type.coding.version
                                                                                                                            Definition

                                                                                                                            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.

                                                                                                                            ShortVersion 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)
                                                                                                                            Control0..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()))
                                                                                                                            488. MedicationRequest.requester.identifier.type.coding.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).

                                                                                                                            ShortSymbol in syntax defined by the system
                                                                                                                            Control0..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.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            490. MedicationRequest.requester.identifier.type.coding.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

                                                                                                                            Control0..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()))
                                                                                                                            492. MedicationRequest.requester.identifier.type.coding.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()))
                                                                                                                            494. MedicationRequest.requester.identifier.type.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()))
                                                                                                                            496. MedicationRequest.requester.identifier.system
                                                                                                                            Definition

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

                                                                                                                            ShortThe namespace for the identifier value
                                                                                                                            Comments

                                                                                                                            Identifier.system is always case sensitive.

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

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

                                                                                                                            ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            498. MedicationRequest.requester.identifier.value
                                                                                                                            Definition

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

                                                                                                                            ShortThe value that is unique
                                                                                                                            Comments

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

                                                                                                                            Control0..1
                                                                                                                            Typestring
                                                                                                                            Is Modifierfalse
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Must Supporttrue
                                                                                                                            Summarytrue
                                                                                                                            ExampleGeneral: 123456
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            500. MedicationRequest.requester.identifier.period
                                                                                                                            Definition

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

                                                                                                                            ShortTime period when id is/was valid for use
                                                                                                                            Comments

                                                                                                                            A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                                                            Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                                                            Control0..1
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            TypePeriod
                                                                                                                            Is Modifierfalse
                                                                                                                            Summarytrue
                                                                                                                            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))
                                                                                                                            502. MedicationRequest.requester.identifier.assigner
                                                                                                                            Definition

                                                                                                                            Organization that issued/manages the identifier.

                                                                                                                            ShortOrganization that issued id (may be just text)
                                                                                                                            Comments

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

                                                                                                                            Control0..1
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            TypeReference(Organization)
                                                                                                                            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')))
                                                                                                                            504. MedicationRequest.requester.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
                                                                                                                            Must Supporttrue
                                                                                                                            Summarytrue
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            506. 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')))
                                                                                                                            508. 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()))
                                                                                                                            510. 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')))
                                                                                                                            512. 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..*
                                                                                                                            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
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            514. 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')))
                                                                                                                            516. 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()))
                                                                                                                            518. 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()))
                                                                                                                            520. 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(eMP MedicationRequest)
                                                                                                                            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')))
                                                                                                                            522. MedicationRequest.basedOn.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
                                                                                                                            524. MedicationRequest.basedOn.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.basedOn.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                            • value @ url
                                                                                                                            • 526. MedicationRequest.basedOn.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
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              528. MedicationRequest.basedOn.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()))
                                                                                                                              530. MedicationRequest.basedOn.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)
                                                                                                                              Control0..1
                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                              TypeIdentifier(Profil für den Identifikator eines eMP-Eintrags)
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              532. MedicationRequest.basedOn.identifier.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..0
                                                                                                                              Typestring
                                                                                                                              Is Modifierfalse
                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                              Summaryfalse
                                                                                                                              534. MedicationRequest.basedOn.identifier.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..0
                                                                                                                              TypeExtension
                                                                                                                              Is Modifierfalse
                                                                                                                              Summaryfalse
                                                                                                                              Alternate Namesextensions, user content
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              SlicingThis element introduces a set of slices on MedicationRequest.basedOn.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                              • value @ url
                                                                                                                              • 536. MedicationRequest.basedOn.identifier.use
                                                                                                                                Definition

                                                                                                                                The purpose of this identifier.

                                                                                                                                Shortofficial
                                                                                                                                Comments

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

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

                                                                                                                                Identifies the purpose for this identifier, if known .

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

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

                                                                                                                                Fixed Valueofficial
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                538. MedicationRequest.basedOn.identifier.type
                                                                                                                                Definition

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

                                                                                                                                ShortDescription of identifier
                                                                                                                                Comments

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

                                                                                                                                Control0..1
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                                                (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                                                                                                                TypeCodeableConcept
                                                                                                                                Is Modifierfalse
                                                                                                                                Must Supporttrue
                                                                                                                                Summarytrue
                                                                                                                                Requirements

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

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                540. MedicationRequest.basedOn.identifier.type.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
                                                                                                                                542. MedicationRequest.basedOn.identifier.type.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.basedOn.identifier.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                • value @ url
                                                                                                                                • 544. MedicationRequest.basedOn.identifier.type.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()))
                                                                                                                                  546. MedicationRequest.basedOn.identifier.type.coding.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
                                                                                                                                  548. MedicationRequest.basedOn.identifier.type.coding.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.basedOn.identifier.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                  • value @ url
                                                                                                                                  • 550. MedicationRequest.basedOn.identifier.type.coding.system
                                                                                                                                    Definition

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

                                                                                                                                    ShortIdentity 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.

                                                                                                                                    Control0..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.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    552. MedicationRequest.basedOn.identifier.type.coding.version
                                                                                                                                    Definition

                                                                                                                                    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.

                                                                                                                                    ShortVersion 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)
                                                                                                                                    Control0..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()))
                                                                                                                                    554. MedicationRequest.basedOn.identifier.type.coding.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).

                                                                                                                                    ShortSymbol in syntax defined by the system
                                                                                                                                    Control0..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.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    556. MedicationRequest.basedOn.identifier.type.coding.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

                                                                                                                                    Control0..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()))
                                                                                                                                    558. MedicationRequest.basedOn.identifier.type.coding.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()))
                                                                                                                                    560. MedicationRequest.basedOn.identifier.type.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()))
                                                                                                                                    562. MedicationRequest.basedOn.identifier.system
                                                                                                                                    Definition

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

                                                                                                                                    ShortThe namespace for the identifier value
                                                                                                                                    Comments

                                                                                                                                    Identifier.system is always case sensitive.

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

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

                                                                                                                                    Pattern Valuehttps://gematik.de/fhir/sid/emp-identifier
                                                                                                                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    564. MedicationRequest.basedOn.identifier.value
                                                                                                                                    Definition

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

                                                                                                                                    ShortDer eindeutige Identifikationswert
                                                                                                                                    Comments

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

                                                                                                                                    Control1..1
                                                                                                                                    Typestring
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                    Must Supporttrue
                                                                                                                                    Summarytrue
                                                                                                                                    ExampleGeneral: 123456
                                                                                                                                    General: 687512ce-744c-8001-83c3-238227110dd6
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    566. MedicationRequest.basedOn.identifier.period
                                                                                                                                    Definition

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

                                                                                                                                    ShortTime period when id is/was valid for use
                                                                                                                                    Comments

                                                                                                                                    A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                                                                    Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                                                                    Control0..0
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypePeriod
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Summarytrue
                                                                                                                                    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))
                                                                                                                                    568. MedicationRequest.basedOn.identifier.assigner
                                                                                                                                    Definition

                                                                                                                                    Organization that issued/manages the identifier.

                                                                                                                                    ShortOrganization that issued id (may be just text)
                                                                                                                                    Comments

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

                                                                                                                                    Control0..0
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeReference(Organization)
                                                                                                                                    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')))
                                                                                                                                    570. MedicationRequest.basedOn.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
                                                                                                                                    Must Supporttrue
                                                                                                                                    Summarytrue
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    572. 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()))
                                                                                                                                    574. 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()))
                                                                                                                                    576. 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')))
                                                                                                                                    578. MedicationRequest.note
                                                                                                                                    Definition

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

                                                                                                                                    ShortInformation 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()))
                                                                                                                                    580. 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
                                                                                                                                    582. 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
                                                                                                                                    • 584. 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()))
                                                                                                                                      586. MedicationRequest.note.time
                                                                                                                                      Definition

                                                                                                                                      Indicates when this particular annotation was made.

                                                                                                                                      ShortWhen the annotation was made
                                                                                                                                      Control0..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()))
                                                                                                                                      588. MedicationRequest.note.text
                                                                                                                                      Definition

                                                                                                                                      Instructions to the pharmacy that go beyond the dosage information

                                                                                                                                      ShortDispensing Note
                                                                                                                                      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()))
                                                                                                                                      590. 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.

                                                                                                                                      Control0..*
                                                                                                                                      TypeDosage(Dosage dgMP)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supporttrue
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      592. MedicationRequest.dosageInstruction.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
                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                      594. MedicationRequest.dosageInstruction.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..*
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      TypeExtension
                                                                                                                                      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.dosageInstruction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                      • value @ url
                                                                                                                                      • 596. MedicationRequest.dosageInstruction.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..*
                                                                                                                                        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 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())
                                                                                                                                        598. MedicationRequest.dosageInstruction.sequence
                                                                                                                                        Definition

                                                                                                                                        Indicates the order in which the dosage instructions should be applied or interpreted.

                                                                                                                                        ShortThe order of the dosage instructions
                                                                                                                                        Comments

                                                                                                                                        Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                        Control0..0
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        Typeinteger
                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

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

                                                                                                                                        Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker

                                                                                                                                        ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'
                                                                                                                                        Comments

                                                                                                                                        Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.

                                                                                                                                        Control0..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        Typestring
                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                        Must Supporttrue
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

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

                                                                                                                                        Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                                                                                                                                        ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                                                                                                                                        Comments

                                                                                                                                        Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                                                                                                                                        Control0..0
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

                                                                                                                                        A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                                                                                                                                        TypeCodeableConcept
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

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

                                                                                                                                        Instructions in terms that are understood by the patient or consumer.

                                                                                                                                        ShortPatient or consumer oriented instructions
                                                                                                                                        Comments

                                                                                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                                                        Control0..0
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        Typestring
                                                                                                                                        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()))
                                                                                                                                        606. MedicationRequest.dosageInstruction.timing
                                                                                                                                        Definition

                                                                                                                                        Specifies an event that may occur multiple times. Timing schedules are used to record when things are planned, expected or requested to occur. The most common usage is in dosage instructions for medications. They are also used when planning care of various kinds, and may be used for reporting the schedule to which past regular activities were carried out.

                                                                                                                                        ShortA timing schedule that specifies an event that may occur multiple times
                                                                                                                                        Comments

                                                                                                                                        Describes the occurrence of an event that may occur multiple times. Timing schedules are used for specifying when events are expected or requested to occur, and may also be used to represent the summary of a past or ongoing event. For simplicity, the definitions of Timing components are expressed as 'future' events, but such components can also be used to describe historic or ongoing events.

                                                                                                                                        A Timing schedule can be a list of events and/or criteria for when the event happens, which can be expressed in a structured form and/or as a code. When both event and a repeating specification are provided, the list of events should be understood as an interpretation of the information in the repeat structure.

                                                                                                                                        Control0..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeTiming(Timing dgMP)
                                                                                                                                        Must Supporttrue
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        608. MedicationRequest.dosageInstruction.asNeeded[x]
                                                                                                                                        Definition

                                                                                                                                        Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                                                                                                                        ShortTake "as needed" (for x)
                                                                                                                                        Comments

                                                                                                                                        Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                        Control0..0
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

                                                                                                                                        A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

                                                                                                                                        TypeChoice of: boolean, CodeableConcept
                                                                                                                                        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()))
                                                                                                                                        610. MedicationRequest.dosageInstruction.site
                                                                                                                                        Definition

                                                                                                                                        Body site to administer to.

                                                                                                                                        ShortBody site to administer to
                                                                                                                                        Comments

                                                                                                                                        Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                        Control0..0
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

                                                                                                                                        A coded concept describing the site location the medicine enters into or onto the body.

                                                                                                                                        TypeCodeableConcept
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        A coded specification of the anatomic site where the medication first enters the body.

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

                                                                                                                                        How drug should enter body.

                                                                                                                                        ShortHow drug should enter body
                                                                                                                                        Comments

                                                                                                                                        Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                        Control0..0
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        BindingFor example codes, see SNOMEDCTRouteCodes
                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

                                                                                                                                        A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                                                                                                                                        TypeCodeableConcept
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

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

                                                                                                                                        Technique for administering medication.

                                                                                                                                        ShortTechnique for administering medication
                                                                                                                                        Comments

                                                                                                                                        Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                        Control0..0
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

                                                                                                                                        A coded concept describing the technique by which the medicine is administered.

                                                                                                                                        TypeCodeableConcept
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

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

                                                                                                                                        Die verabreichte Menge des Medikaments.

                                                                                                                                        ShortMenge des verabreichten Medikaments
                                                                                                                                        Comments

                                                                                                                                        Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                        Control0..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeElement
                                                                                                                                        Must Supporttrue
                                                                                                                                        Summarytrue
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        618. MedicationRequest.dosageInstruction.doseAndRate.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
                                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                        620. MedicationRequest.dosageInstruction.doseAndRate.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..*
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeExtension
                                                                                                                                        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.dosageInstruction.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                        • value @ url
                                                                                                                                        • 622. MedicationRequest.dosageInstruction.doseAndRate.type
                                                                                                                                          Definition

                                                                                                                                          The kind of dose or rate specified, for example, ordered or calculated.

                                                                                                                                          ShortThe kind of dose or rate specified
                                                                                                                                          Comments

                                                                                                                                          Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                          Control0..0
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          BindingFor example codes, see DoseAndRateType
                                                                                                                                          (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                                                                                                                                          The kind of dose or rate specified.

                                                                                                                                          TypeCodeableConcept
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          If the type is not populated, assume to be "ordered".

                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          624. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                                                                                                                                          Definition

                                                                                                                                          The comparator is not used on a SimpleQuantity

                                                                                                                                          ShortA fixed quantity (no comparator)
                                                                                                                                          Comments

                                                                                                                                          Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                          Control0..1
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          TypeQuantity(SimpleQuantity)
                                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Must Supporttrue
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          The amount of therapeutic or other substance given at one administration event.

                                                                                                                                          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())
                                                                                                                                          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                                          • type @ $this
                                                                                                                                          • 626. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity
                                                                                                                                            Slice NamedoseQuantity
                                                                                                                                            Definition

                                                                                                                                            Menge des Medikaments pro Dosis.

                                                                                                                                            ShortMenge des Medikaments pro Dosis
                                                                                                                                            Comments

                                                                                                                                            Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.

                                                                                                                                            Control0..1
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
                                                                                                                                            (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                                                                                                                                            TypeQuantity(SimpleQuantity)
                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                            Must Supporttrue
                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            The amount of therapeutic or other substance given at one administration event.

                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            628. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.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
                                                                                                                                            630. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.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.dosageInstruction.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                            • value @ url
                                                                                                                                            • 632. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
                                                                                                                                              Definition

                                                                                                                                              The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                                                              ShortNumerical value (with implicit precision)
                                                                                                                                              Comments

                                                                                                                                              The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

                                                                                                                                              Precision is handled implicitly in almost all cases of measurement.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              634. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator
                                                                                                                                              Definition

                                                                                                                                              Not allowed to be used in this context

                                                                                                                                              Short< | <= | >= | > - how to understand the value
                                                                                                                                              Control0..0
                                                                                                                                              BindingThe codes SHALL be taken from QuantityComparator
                                                                                                                                              (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                                                              How the Quantity should be understood and represented.

                                                                                                                                              Typecode
                                                                                                                                              Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                                                              Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              636. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit
                                                                                                                                              Definition

                                                                                                                                              A human-readable form of the unit.

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

                                                                                                                                              There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              638. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system
                                                                                                                                              Definition

                                                                                                                                              The identification of the system that provides the coded form of the unit.

                                                                                                                                              ShortSystem that defines coded unit form
                                                                                                                                              Control1..1
                                                                                                                                              This element is affected by the following invariants: qty-3
                                                                                                                                              Typeuri
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                              Must Supporttrue
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              Need to know the system that defines the coded form of the unit.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              640. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code
                                                                                                                                              Definition

                                                                                                                                              A computer processable form of the unit in some unit representation system.

                                                                                                                                              ShortCoded form of the unit
                                                                                                                                              Comments

                                                                                                                                              The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

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

                                                                                                                                              Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              642. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
                                                                                                                                              Definition

                                                                                                                                              Amount of medication per unit of time.

                                                                                                                                              ShortAmount of medication per unit of time
                                                                                                                                              Comments

                                                                                                                                              Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                              Control0..0
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

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

                                                                                                                                              Upper limit on medication per unit of time.

                                                                                                                                              ShortUpper limit on medication per unit of time
                                                                                                                                              Comments

                                                                                                                                              Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                              Control0..0
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeRatio
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                                                                                              646. MedicationRequest.dosageInstruction.maxDosePerAdministration
                                                                                                                                              Definition

                                                                                                                                              Upper limit on medication per administration.

                                                                                                                                              ShortUpper limit on medication per administration
                                                                                                                                              Comments

                                                                                                                                              Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                              Control0..0
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeQuantity(SimpleQuantity)
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                                                                                                                              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())
                                                                                                                                              648. MedicationRequest.dosageInstruction.maxDosePerLifetime
                                                                                                                                              Definition

                                                                                                                                              Upper limit on medication per lifetime of the patient.

                                                                                                                                              ShortUpper limit on medication per lifetime of the patient
                                                                                                                                              Comments

                                                                                                                                              Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                                                                                                              Control0..0
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeQuantity(SimpleQuantity)
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                                                                                                                              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())
                                                                                                                                              650. 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
                                                                                                                                              Must Supporttrue
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              652. 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
                                                                                                                                              654. 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
                                                                                                                                              • 656. 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())
                                                                                                                                                658. 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()))
                                                                                                                                                660. 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
                                                                                                                                                662. 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
                                                                                                                                                • 664. 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())
                                                                                                                                                  666. 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())
                                                                                                                                                  668. 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())
                                                                                                                                                  670. 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())
                                                                                                                                                  672. 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))
                                                                                                                                                  674. 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()))
                                                                                                                                                  676. 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
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  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())
                                                                                                                                                  678. MedicationRequest.dispenseRequest.quantity.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
                                                                                                                                                  680. MedicationRequest.dispenseRequest.quantity.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.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                  • value @ url
                                                                                                                                                  • 682. MedicationRequest.dispenseRequest.quantity.value
                                                                                                                                                    Definition

                                                                                                                                                    Number of Prescribed Packages

                                                                                                                                                    ShortNumber of Prescribed Packages
                                                                                                                                                    Comments

                                                                                                                                                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

                                                                                                                                                    Precision is handled implicitly in almost all cases of measurement.

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

                                                                                                                                                    Not allowed to be used in this context

                                                                                                                                                    Short< | <= | >= | > - how to understand the value
                                                                                                                                                    Control0..0
                                                                                                                                                    BindingThe codes SHALL be taken from QuantityComparator
                                                                                                                                                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                                                                    How the Quantity should be understood and represented.

                                                                                                                                                    Typecode
                                                                                                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                                                                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    686. MedicationRequest.dispenseRequest.quantity.unit
                                                                                                                                                    Definition

                                                                                                                                                    A human-readable form of the unit.

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

                                                                                                                                                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

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

                                                                                                                                                    The identification of the system that provides the coded form of the unit.

                                                                                                                                                    ShortSystem that defines coded unit form
                                                                                                                                                    Control0..1
                                                                                                                                                    This element is affected by the following invariants: qty-3
                                                                                                                                                    Typeuri
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Must Supporttrue
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    Need to know the system that defines the coded form of the unit.

                                                                                                                                                    Pattern Valuehttp://unitsofmeasure.org
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    690. MedicationRequest.dispenseRequest.quantity.code
                                                                                                                                                    Definition

                                                                                                                                                    A computer processable form of the unit in some unit representation system.

                                                                                                                                                    ShortCoded form of the unit
                                                                                                                                                    Comments

                                                                                                                                                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

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

                                                                                                                                                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    692. 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
                                                                                                                                                    Must Supporttrue
                                                                                                                                                    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())
                                                                                                                                                    694. 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')))
                                                                                                                                                    696. 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
                                                                                                                                                    Must Supporttrue
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    698. 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
                                                                                                                                                    700. 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
                                                                                                                                                    • 702. 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())
                                                                                                                                                      704. 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
                                                                                                                                                      Typeboolean
                                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      706. 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()))
                                                                                                                                                      708. 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')))
                                                                                                                                                      710. 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')))
                                                                                                                                                      712. 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')))