Implementation Guide
TIFlow - Datenaustausch BfArM Webdienst
Version 2.0.0 - release

Resource Profile: ERP_TPrescription_MedicationRequest - Detailed Descriptions

Active as of 2026-10-02

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

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

ShortA set of rules under which this content was created
Comments

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

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

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

Control0..*
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())
SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. MedicationRequest.extension:context
    Slice Namecontext
    Definition

    Extension for indicating the context.

    ShortExtension
    Comments

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

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(ContextExtension) (Extension Type: code)
    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())
    14. 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
    Comments

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

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(MultiplePrescription) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    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())
    16. MedicationRequest.extension:multiplePrescription.extension:indicator
    Slice Nameindicator
    Definition

    An Extension

    ShortExtensionAdditional content defined by implementations
    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())
    18. 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*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MedicationRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 20. MedicationRequest.extension: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
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valueindicator
      22. 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()))
      24. MedicationRequest.extension:multiplePrescription.extension:counter
      Slice Namecounter
      Definition

      An Extension

      ShortExtensionAdditional content defined by implementations
      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())
      26. 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*
      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
      • 28. 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
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed Valuecounter
        30. 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()))
        32. 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())
        34. 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()))
        36. 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()))
        38. 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()))
        40. 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()))
        42. 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()))
        44. 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())
        46. 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()))
        48. 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()))
        50. 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()))
        52. 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()))
        54. 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()))
        56. MedicationRequest.extension:multiplePrescription.extension:period
        Slice Nameperiod
        Definition

        An Extension

        ShortZeitraum der EinlösefristAdditional content defined by implementations
        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())
        58. 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*
        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
        • 60. 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
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valueperiod
          62. 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)
          64. 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()))
          66. 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()))
          68. MedicationRequest.extension:multiplePrescription.extension:id
          Slice Nameid
          Definition

          An Extension

          ShortExtensionAdditional content defined by implementations
          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())
          70. 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*
          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
          • 72. 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
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valueid
            74. 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()))
            76. 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()))
            78. 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()))
            80. 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()))
            82. 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()))
            84. 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))
            86. 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')))
            88. 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
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
            90. 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()))
            92. MedicationRequest.extension:isBvg
            Slice NameisBvg
            Definition

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

            ShortExtension
            Comments

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(IndicatorBVGExtension) (Extension Type: boolean)
            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())
            94. MedicationRequest.extension:isSer
            Slice NameisSer
            Definition

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

            ShortExtension
            Comments

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(IndicatorSERExtension) (Extension Type: boolean)
            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())
            96. MedicationRequest.extension:prescriberID
            Slice NameprescriberID
            Definition

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

            ShortExtension
            Comments

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

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(PrescriberIDExtension) (Extension Type: Identifier)
            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())
            98. 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*
            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
            • 100. 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
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/prescriber-id-extension
              102. 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()))
              104. 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()))
              106. 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
              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()))
              108. 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
              Summarytrue
              ExampleGeneral: 123456
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              110. 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))
              112. 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')))
              114. MedicationRequest.extension:patientID
              Slice NamepatientID
              Definition

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

              ShortExtension
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(PatientIDExtension) (Extension Type: Identifier)
              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())
              116. MedicationRequest.extension:narcotics
              Slice Namenarcotics
              Definition

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

              ShortBetäubungsmittel (BtM)
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(NarcoticsExtension) (Complex Extension)
              Is Modifierfalse
              Must Supporttrue
              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())
              118. MedicationRequest.extension:narcotics.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..*
              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())
              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
              • 120. MedicationRequest.extension:narcotics.extension:narcotics-markings
                Slice Namenarcotics-markings
                Definition

                An Extension

                ShortExtensionAdditional content defined by implementations
                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())
                122. MedicationRequest.extension:narcotics.extension:narcotics-markings.extension
                Definition

                An Extension


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

                ShortExtensionAdditional content defined by implementations
                Comments

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

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

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

                  Shortidentifies the meaning of the extension
                  Comments

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

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuenarcotics-markings
                  126. MedicationRequest.extension:narcotics.extension:narcotics-markings.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
                  Comments

                  Die KBV aktualisiert ihr "Schüsseltabellen"-Paket häufiger, als neue ePA-Versionen veröffentlicht werden. Allerdings übernehmen die E-Rezept-Clients und der E-Rezept-Fachdienst neue KBV-Paketversionen schnell nach deren Veröffentlichung und geben sie somit an den ePA-MedicationService weiter. Da der MedicationService möglicherweise an eine ältere Version des KBV-Pakets gebunden ist, würde er die weitergeleiteten E-Rezept-Daten ablehnen. Zukünftig wird der MedicationService in der Lage sein, auf die neuesten KBV-Paketversionen zu aktualisieren, ohne dass eine neue ePA-Version erforderlich ist. Da das E-Rezept tatsächlich die Codes gegen die neueste KBV-Paketversion prüft, wird der MedicationService keine "ungültigen" Codes erhalten, und die Clients können darauf vertrauen, dass die Daten des MedicationService mit der neuesten KBV-Paketversion übereinstimmen.

                  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_KBV_NARCOTIC_LABEL
                  (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NARCOTIC_LABEL)
                  TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, 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
                  Pattern Value{
                    "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_NARCOTIC_LABEL"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  128. MedicationRequest.extension:narcotics.extension:narcotics-markings.value[x].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()))
                  130. MedicationRequest.extension:narcotics.extension:narcotics-markings.value[x].code
                  Definition

                  Kennzeichen nach § 9 Abs. 1 Nr. 6 BtMVV


                  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).

                  ShortKennzeichen nach § 9 Abs. 1 Nr. 6 BtMVVSymbol 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()))
                  132. MedicationRequest.extension:narcotics.extension:additional-information-substitutes
                  Slice Nameadditional-information-substitutes
                  Definition

                  An Extension

                  ShortExtensionAdditional content defined by implementations
                  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())
                  134. MedicationRequest.extension:narcotics.extension:additional-information-substitutes.extension
                  Definition

                  An Extension


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

                  ShortExtensionAdditional content defined by implementations
                  Comments

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

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

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

                    Shortidentifies the meaning of the extension
                    Comments

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

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valueadditional-information-substitutes
                    138. MedicationRequest.extension:narcotics.extension:additional-information-substitutes.value[x]
                    Definition

                    Dieses Feld enthält ergänzende Angaben zu Reichdauer und Teilmengen des Substitutionsmittels, insbesondere Zeitpunkte, zu denen das Substitutionsmittel abgegeben bzw. verabreicht werden soll.


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

                    ShortErgänzende Angaben zu SubstitutionsmittelValue of extension
                    Control0..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()))
                    140. MedicationRequest.extension:narcotics.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    Comments

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

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/narcotics-extension
                    142. MedicationRequest.extension:narcotics.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()))
                    144. MedicationRequest.extension:teratogenic
                    Slice Nameteratogenic
                    Definition

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

                    ShortT-Rezept
                    Comments

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

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(TeratogenicExtension) (Complex Extension)
                    Is Modifierfalse
                    Must Supporttrue
                    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())
                    146. 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).
                    Comments

                    Element MedicationRequest.renderedDosageInstruction has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.renderedDosageInstruction has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(R5: Full representation of the dosage instructions (new)) (Extension Type: markdown)
                    Is Modifierfalse
                    Must Supporttrue
                    Standard StatusNormative (from Trial Use)
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    148. MedicationRequest.extension:renderedDosageInstruction.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. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 150. 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
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
                      152. MedicationRequest.extension:renderedDosageInstruction.value[x]
                      Definition

                      The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.


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

                      ShortFull representation of the dosage instructionsValue of extension
                      Control0..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
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      154. 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
                      Comments

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

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Generated Dosage Instructions Meta) (Complex Extension)
                      Is Modifierfalse
                      Must Supporttrue
                      Standard StatusNormative (from Trial Use)
                      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())
                      156. 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())
                      158. 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..0*
                      TypeIdentifier
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • pattern @ $this
                      • 160. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
                        Slice NameRxPrescriptionProcessIdentifier
                        Definition

                        An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


                        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.

                        ShortAn identifier intended for computationExternal 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..0*
                        This element is affected by the following invariants: ele-1
                        TypeIdentifier(RxPrescriptionProcessIdentifier)
                        Is Modifierfalse
                        Summaryfalse
                        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()))
                        162. MedicationRequest.identifier:RxOriginatorProcessIdentifier
                        Slice NameRxOriginatorProcessIdentifier
                        Definition

                        An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


                        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.

                        ShortAn identifier intended for computationExternal 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..0*
                        This element is affected by the following invariants: ele-1
                        TypeIdentifier(RxOriginatorProcessIdentifier)
                        Is Modifierfalse
                        Summaryfalse
                        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()))
                        164. 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 https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vshttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
                        (required to https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs)

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

                        Typecode
                        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Fixed Valuecompleted
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        166. 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..01
                        BindingFor example codes, see medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

                        Identifies the reasons for a given status.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        168. 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
                        Fixed Valueorder
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        170. 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..0*
                        BindingFor example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

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

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

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

                        Shortroutine | urgent | asap | stat
                        Control0..01
                        BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

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

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        174. 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..01
                        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()))
                        176. 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..01
                        TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                        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()))
                        178. 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
                        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()))
                        180. MedicationRequest.subject
                        Definition

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

                        ShortWho or group medication request is for
                        Comments

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

                        Control1..1
                        TypeReference(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()))
                        182. 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..01
                        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()))
                        184. 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..01
                        BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types|4.0.1
                        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                        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()))
                        186. MedicationRequest.subject.identifier
                        Definition

                        An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


                        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.

                        ShortAn identifier intended for computationLogical 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()))
                        188. 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..01
                        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()))
                        190. 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..01
                        TypeReference(Encounter, Encounter)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        192. MedicationRequest.supportingInformation
                        Definition

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

                        ShortInformation to support ordering of the medication
                        Control0..0*
                        TypeReference(Resource, Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        194. 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()))
                        196. MedicationRequest.requester
                        Definition

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

                        ShortWho/What requested the Request
                        Control0..01
                        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()))
                        198. MedicationRequest.performer
                        Definition

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

                        ShortIntended performer of administration
                        Control0..01
                        TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam, Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        200. 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..01
                        BindingFor example codes, see ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-role|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/performer-role)

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

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

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

                        ShortPerson who entered the request
                        Control0..01
                        TypeReference(Practitioner, PractitionerRole, Practitioner, PractitionerRole)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        204. 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..0*
                        BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/condition-code)

                        A coded concept indicating why the medication was ordered.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        206. 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..0*
                        TypeReference(Condition, Observation, Condition, Observation)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        208. MedicationRequest.instantiatesCanonical
                        Definition

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

                        ShortInstantiates FHIR protocol or definition
                        Control0..0*
                        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()))
                        210. MedicationRequest.instantiatesUri
                        Definition

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

                        ShortInstantiates external protocol or definition
                        Control0..0*
                        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()))
                        212. MedicationRequest.basedOn
                        Definition

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

                        ShortWhat request fulfills
                        Control0..0*
                        TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation, CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                        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()))
                        216. 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..01
                        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()))
                        218. 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..01
                        BindingFor example codes, see medicationRequest Course of Therapy Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

                        Identifies the overall pattern of medication administratio.

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

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

                        ShortAssociated insurance coverage
                        Control0..0*
                        TypeReference(Coverage, ClaimResponse, Coverage, ClaimResponse)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        222. MedicationRequest.note
                        Definition

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

                        ShortInformation about the prescription
                        Control0..0*
                        TypeAnnotation
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        225. 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
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
                        DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies timing.exists()) ))
                        DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Quantity).code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).low.code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).high.code ).distinct().count() = 1 ))
                        DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. (text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())
                        FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
                        DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
                        DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ))
                        FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
                        FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer) UND die Extension renderedDosageInstruction befüllt ist, muss der Wert in dosageInstruction.text mit dem Wert in der Extension übereinstimmen. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationDispense).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationStatement).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) ) ))
                        227. MedicationRequest.dispenseRequest
                        Definition

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

                        ShortMedication supply authorization
                        Control0..1
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        229. 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())
                        231. 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..01
                        TypeBackboneElement
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        234. MedicationRequest.dispenseRequest.dispenseInterval
                        Definition

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

                        ShortMinimum period of time between dispenses
                        Control0..01
                        TypeDuration
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        236. 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..01
                        TypePeriod
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        238. 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..01
                        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()))
                        240. MedicationRequest.dispenseRequest.quantity
                        Definition

                        The amount that is to be dispensed for one fill.

                        ShortAmount of medication to supply per dispense
                        Control0..1
                        TypeQuantity(SimpleQuantity, SimpleQuantity)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        242. 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()))
                        244. 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()))
                        246. 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()))
                        248. 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()))
                        250. 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()))
                        252. 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
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        254. MedicationRequest.dispenseRequest.performer
                        Definition

                        Indicates the intended dispensing Organization specified by the prescriber.

                        ShortIntended dispenser
                        Control0..01
                        TypeReference(Organization, Organization)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        256. 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..01
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        260. MedicationRequest.priorPrescription
                        Definition

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

                        ShortAn order/prescription that is being replaced
                        Control0..01
                        TypeReference(MedicationRequest, MedicationRequest)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        262. 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..0*
                        TypeReference(DetectedIssue, DetectedIssue)
                        Is Modifierfalse
                        Summaryfalse
                        Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        264. 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..0*
                        TypeReference(Provenance, Provenance)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                        0. MedicationRequest
                        2. MedicationRequest.extension
                        Must Supporttrue
                        4. MedicationRequest.identifier
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..0
                        6. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
                        Slice NameRxPrescriptionProcessIdentifier
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..0
                        8. MedicationRequest.identifier:RxOriginatorProcessIdentifier
                        Slice NameRxOriginatorProcessIdentifier
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..0
                        10. MedicationRequest.status
                        Fixed Valuecompleted
                        12. MedicationRequest.statusReason
                        Control0..0
                        14. MedicationRequest.intent
                        Fixed Valueorder
                        16. MedicationRequest.category
                        Control0..0
                        18. MedicationRequest.priority
                        Control0..0
                        20. MedicationRequest.doNotPerform
                        Control0..0
                        22. MedicationRequest.reported[x]
                        Control0..0
                        24. MedicationRequest.subject
                        26. MedicationRequest.subject.reference
                        Control0..0
                        28. MedicationRequest.subject.type
                        Control0..0
                        30. MedicationRequest.subject.display
                        Control0..0
                        32. MedicationRequest.encounter
                        Control0..0
                        34. MedicationRequest.supportingInformation
                        Control0..0
                        36. MedicationRequest.requester
                        Control0..0
                        38. MedicationRequest.performer
                        Control0..0
                        40. MedicationRequest.performerType
                        Control0..0
                        42. MedicationRequest.recorder
                        Control0..0
                        44. MedicationRequest.reasonCode
                        Control0..0
                        46. MedicationRequest.reasonReference
                        Control0..0
                        48. MedicationRequest.instantiatesCanonical
                        Control0..0
                        50. MedicationRequest.instantiatesUri
                        Control0..0
                        52. MedicationRequest.basedOn
                        Control0..0
                        54. MedicationRequest.groupIdentifier
                        Control0..0
                        56. MedicationRequest.courseOfTherapyType
                        Control0..0
                        58. MedicationRequest.insurance
                        Control0..0
                        60. MedicationRequest.note
                        Control0..0
                        62. MedicationRequest.dispenseRequest
                        64. MedicationRequest.dispenseRequest.initialFill
                        Control0..0
                        66. MedicationRequest.dispenseRequest.dispenseInterval
                        Control0..0
                        68. MedicationRequest.dispenseRequest.validityPeriod
                        Control0..0
                        70. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                        Control0..0
                        72. MedicationRequest.dispenseRequest.performer
                        Control0..0
                        74. MedicationRequest.substitution
                        Control0..0
                        76. MedicationRequest.priorPrescription
                        Control0..0
                        78. MedicationRequest.detectedIssue
                        Control0..0
                        80. MedicationRequest.eventHistory
                        Control0..0

                        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
                          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..*
                          BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                          (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                          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..*
                          BindingFor example codes, see CommonTags
                          (example to http://hl7.org/fhir/ValueSet/common-tags)

                          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)

                          A human language.

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

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

                          ShortText summary of the resource, for human interpretation
                          Comments

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

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

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

                          ShortContained, inline Resources
                          Comments

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

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

                          An Extension

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

                            Extension for indicating the context.

                            ShortExtension
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(ContextExtension) (Extension Type: code)
                            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())
                            34. 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
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(MultiplePrescription) (Complex Extension)
                            Is Modifierfalse
                            Must Supporttrue
                            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())
                            36. 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
                            38. MedicationRequest.extension:multiplePrescription.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                            • value @ url
                            • 40. 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())
                              42. 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
                              44. 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
                              • 46. 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
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Fixed Valueindicator
                                48. 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()))
                                50. 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())
                                52. 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
                                54. 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
                                • 56. 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
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Fixed Valuecounter
                                  58. 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()))
                                  60. 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
                                  62. 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
                                  • 64. 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())
                                    66. 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
                                    68. 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
                                    • 70. 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()))
                                      72. 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()))
                                      74. 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()))
                                      76. 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()))
                                      78. 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()))
                                      80. 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())
                                      82. 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
                                      84. 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
                                      • 86. 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()))
                                        88. 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()))
                                        90. 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()))
                                        92. 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()))
                                        94. 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()))
                                        96. MedicationRequest.extension:multiplePrescription.extension:period
                                        Slice Nameperiod
                                        Definition

                                        An Extension

                                        ShortZeitraum der Einlösefrist
                                        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())
                                        98. 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
                                        100. 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
                                        • 102. 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
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Fixed Valueperiod
                                          104. 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)
                                          106. 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
                                          108. 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
                                          • 110. 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()))
                                            112. 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()))
                                            114. 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())
                                            116. 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
                                            118. 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
                                            • 120. 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
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Fixed Valueid
                                              122. 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()))
                                              124. 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
                                              126. 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
                                              • 128. 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()))
                                                130. 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()))
                                                132. 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()))
                                                134. 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()))
                                                136. 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))
                                                138. 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')))
                                                140. 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
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension
                                                142. 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()))
                                                144. MedicationRequest.extension:isBvg
                                                Slice NameisBvg
                                                Definition

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

                                                ShortExtension
                                                Comments

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

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(IndicatorBVGExtension) (Extension Type: boolean)
                                                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())
                                                146. MedicationRequest.extension:isSer
                                                Slice NameisSer
                                                Definition

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

                                                ShortExtension
                                                Comments

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

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(IndicatorSERExtension) (Extension Type: boolean)
                                                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())
                                                148. MedicationRequest.extension:prescriberID
                                                Slice NameprescriberID
                                                Definition

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

                                                ShortExtension
                                                Comments

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

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(PrescriberIDExtension) (Extension Type: Identifier)
                                                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())
                                                150. 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
                                                152. 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
                                                • 154. 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
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/prescriber-id-extension
                                                  156. 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()))
                                                  158. 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
                                                  160. 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
                                                  • 162. 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()))
                                                    164. 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
                                                    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()))
                                                    166. 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
                                                    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()))
                                                    168. 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
                                                    Summarytrue
                                                    ExampleGeneral: 123456
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    170. 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))
                                                    172. 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')))
                                                    174. MedicationRequest.extension:patientID
                                                    Slice NamepatientID
                                                    Definition

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

                                                    ShortExtension
                                                    Comments

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

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(PatientIDExtension) (Extension Type: Identifier)
                                                    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())
                                                    176. MedicationRequest.extension:narcotics
                                                    Slice Namenarcotics
                                                    Definition

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

                                                    ShortBetäubungsmittel (BtM)
                                                    Comments

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

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(NarcoticsExtension) (Complex Extension)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    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())
                                                    178. MedicationRequest.extension:narcotics.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
                                                    180. MedicationRequest.extension:narcotics.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
                                                    • 182. MedicationRequest.extension:narcotics.extension:narcotics-markings
                                                      Slice Namenarcotics-markings
                                                      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())
                                                      184. MedicationRequest.extension:narcotics.extension:narcotics-markings.id
                                                      Definition

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

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

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

                                                        Shortidentifies the meaning of the extension
                                                        Comments

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

                                                        Control1..1
                                                        Typeuri
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Fixed Valuenarcotics-markings
                                                        190. MedicationRequest.extension:narcotics.extension:narcotics-markings.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
                                                        Comments

                                                        Die KBV aktualisiert ihr "Schüsseltabellen"-Paket häufiger, als neue ePA-Versionen veröffentlicht werden. Allerdings übernehmen die E-Rezept-Clients und der E-Rezept-Fachdienst neue KBV-Paketversionen schnell nach deren Veröffentlichung und geben sie somit an den ePA-MedicationService weiter. Da der MedicationService möglicherweise an eine ältere Version des KBV-Pakets gebunden ist, würde er die weitergeleiteten E-Rezept-Daten ablehnen. Zukünftig wird der MedicationService in der Lage sein, auf die neuesten KBV-Paketversionen zu aktualisieren, ohne dass eine neue ePA-Version erforderlich ist. Da das E-Rezept tatsächlich die Codes gegen die neueste KBV-Paketversion prüft, wird der MedicationService keine "ungültigen" Codes erhalten, und die Clients können darauf vertrauen, dass die Daten des MedicationService mit der neuesten KBV-Paketversion übereinstimmen.

                                                        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_KBV_NARCOTIC_LABEL
                                                        (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NARCOTIC_LABEL)
                                                        TypeCoding
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Pattern Value{
                                                          "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_NARCOTIC_LABEL"
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        192. MedicationRequest.extension:narcotics.extension:narcotics-markings.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
                                                        194. MedicationRequest.extension:narcotics.extension:narcotics-markings.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
                                                        • 196. MedicationRequest.extension:narcotics.extension:narcotics-markings.value[x].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()))
                                                          198. MedicationRequest.extension:narcotics.extension:narcotics-markings.value[x].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
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          200. MedicationRequest.extension:narcotics.extension:narcotics-markings.value[x].code
                                                          Definition

                                                          Kennzeichen nach § 9 Abs. 1 Nr. 6 BtMVV

                                                          ShortKennzeichen nach § 9 Abs. 1 Nr. 6 BtMVV
                                                          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()))
                                                          202. MedicationRequest.extension:narcotics.extension:narcotics-markings.value[x].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
                                                          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()))
                                                          204. MedicationRequest.extension:narcotics.extension:narcotics-markings.value[x].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()))
                                                          206. MedicationRequest.extension:narcotics.extension:additional-information-substitutes
                                                          Slice Nameadditional-information-substitutes
                                                          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())
                                                          208. MedicationRequest.extension:narcotics.extension:additional-information-substitutes.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
                                                          210. MedicationRequest.extension:narcotics.extension:additional-information-substitutes.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
                                                          • 212. MedicationRequest.extension:narcotics.extension:additional-information-substitutes.url
                                                            Definition

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

                                                            Shortidentifies the meaning of the extension
                                                            Comments

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

                                                            Control1..1
                                                            Typeuri
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed Valueadditional-information-substitutes
                                                            214. MedicationRequest.extension:narcotics.extension:additional-information-substitutes.value[x]
                                                            Definition

                                                            Dieses Feld enthält ergänzende Angaben zu Reichdauer und Teilmengen des Substitutionsmittels, insbesondere Zeitpunkte, zu denen das Substitutionsmittel abgegeben bzw. verabreicht werden soll.

                                                            ShortErgänzende Angaben zu Substitutionsmittel
                                                            Control0..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()))
                                                            216. MedicationRequest.extension:narcotics.url
                                                            Definition

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

                                                            Shortidentifies the meaning of the extension
                                                            Comments

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

                                                            Control1..1
                                                            Typeuri
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/narcotics-extension
                                                            218. MedicationRequest.extension:narcotics.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()))
                                                            220. MedicationRequest.extension:teratogenic
                                                            Slice Nameteratogenic
                                                            Definition

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

                                                            ShortT-Rezept
                                                            Comments

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

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(TeratogenicExtension) (Complex Extension)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            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())
                                                            222. 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).
                                                            Comments

                                                            Element MedicationRequest.renderedDosageInstruction has a context of MedicationRequest based on following the parent source element upwards and mapping to MedicationRequest. Element MedicationRequest.renderedDosageInstruction has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(R5: Full representation of the dosage instructions (new)) (Extension Type: markdown)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Standard StatusNormative (from Trial Use)
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            224. 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
                                                            226. MedicationRequest.extension:renderedDosageInstruction.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. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 228. 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
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction
                                                              230. MedicationRequest.extension:renderedDosageInstruction.value[x]
                                                              Definition

                                                              The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses.

                                                              ShortFull representation of the dosage instructions
                                                              Control0..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
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              232. 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
                                                              Comments

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

                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension(Generated Dosage Instructions Meta) (Complex Extension)
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Standard StatusNormative (from Trial Use)
                                                              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())
                                                              234. 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())
                                                              236. 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..0
                                                              TypeIdentifier
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              SlicingThis element introduces a set of slices on MedicationRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • pattern @ $this
                                                              • 238. MedicationRequest.identifier:RxPrescriptionProcessIdentifier
                                                                Slice NameRxPrescriptionProcessIdentifier
                                                                Definition

                                                                An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                                                                ShortAn identifier intended for computation
                                                                Comments

                                                                This is a business identifier, not a resource identifier.

                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                Control0..0
                                                                This element is affected by the following invariants: ele-1
                                                                TypeIdentifier(RxPrescriptionProcessIdentifier)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                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()))
                                                                240. MedicationRequest.identifier:RxOriginatorProcessIdentifier
                                                                Slice NameRxOriginatorProcessIdentifier
                                                                Definition

                                                                An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                                                                ShortAn identifier intended for computation
                                                                Comments

                                                                This is a business identifier, not a resource identifier.

                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                Control0..0
                                                                This element is affected by the following invariants: ele-1
                                                                TypeIdentifier(RxOriginatorProcessIdentifier)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                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()))
                                                                242. 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 https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs
                                                                (required to https://gematik.de/fhir/terminology/ValueSet/ti-medication-request-status-vs)

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

                                                                Typecode
                                                                Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Fixed Valuecompleted
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                244. 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..0
                                                                BindingFor example codes, see medicationRequest Status Reason Codes
                                                                (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

                                                                Identifies the reasons for a given status.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                246. 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
                                                                Fixed Valueorder
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                248. 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..0
                                                                BindingFor example codes, see medicationRequest Category Codes
                                                                (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

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

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

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

                                                                Shortroutine | urgent | asap | stat
                                                                Control0..0
                                                                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()))
                                                                252. 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..0
                                                                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()))
                                                                254. 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..0
                                                                TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                                                                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()))
                                                                256. 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
                                                                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()))
                                                                258. MedicationRequest.subject
                                                                Definition

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

                                                                ShortWho or group medication request is for
                                                                Comments

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

                                                                Control1..1
                                                                TypeReference(Patient)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                260. 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
                                                                262. 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
                                                                • 264. 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..0
                                                                  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()))
                                                                  266. 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..0
                                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                                  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()))
                                                                  268. MedicationRequest.subject.identifier
                                                                  Definition

                                                                  An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                                                                  ShortAn identifier intended for computation
                                                                  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()))
                                                                  270. 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..0
                                                                  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()))
                                                                  272. 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..0
                                                                  TypeReference(Encounter)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  274. MedicationRequest.supportingInformation
                                                                  Definition

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

                                                                  ShortInformation to support ordering of the medication
                                                                  Control0..0
                                                                  TypeReference(Resource)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  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

                                                                  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()))
                                                                  278. MedicationRequest.requester
                                                                  Definition

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

                                                                  ShortWho/What requested the Request
                                                                  Control0..0
                                                                  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()))
                                                                  280. MedicationRequest.performer
                                                                  Definition

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

                                                                  ShortIntended performer of administration
                                                                  Control0..0
                                                                  TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  282. 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..0
                                                                  BindingFor example codes, see ProcedurePerformerRoleCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/performer-role)

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

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

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

                                                                  ShortPerson who entered the request
                                                                  Control0..0
                                                                  TypeReference(Practitioner, PractitionerRole)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  286. 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..0
                                                                  BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/condition-code)

                                                                  A coded concept indicating why the medication was ordered.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  288. 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..0
                                                                  TypeReference(Condition, Observation)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  290. MedicationRequest.instantiatesCanonical
                                                                  Definition

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

                                                                  ShortInstantiates FHIR protocol or definition
                                                                  Control0..0
                                                                  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()))
                                                                  292. MedicationRequest.instantiatesUri
                                                                  Definition

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

                                                                  ShortInstantiates external protocol or definition
                                                                  Control0..0
                                                                  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()))
                                                                  294. MedicationRequest.basedOn
                                                                  Definition

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

                                                                  ShortWhat request fulfills
                                                                  Control0..0
                                                                  TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                                                                  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()))
                                                                  302. 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..0
                                                                  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()))
                                                                  304. 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..0
                                                                  BindingFor example codes, see medicationRequest Course of Therapy Codes
                                                                  (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

                                                                  Identifies the overall pattern of medication administratio.

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

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

                                                                  ShortAssociated insurance coverage
                                                                  Control0..0
                                                                  TypeReference(Coverage, ClaimResponse)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  308. MedicationRequest.note
                                                                  Definition

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

                                                                  ShortInformation about the prescription
                                                                  Control0..0
                                                                  TypeAnnotation
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  315. 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
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
                                                                  DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies timing.exists()) ))
                                                                  DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Quantity).code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).low.code | (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).doseAndRate.dose.ofType(Range).high.code ).distinct().count() = 1 ))
                                                                  DosageWarnungViererschemaInText: Hinweis: In Dosage.text wurde ein Viererschema (z. B. 1-1-1-1) erkannt. Bitte prüfen, ob dies strukturiert abgebildet werden kann. (text.exists() implies text.matches('.*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\s*\\d+\\s*[-–]\\d+.*').not())
                                                                  FreeTextSingleDosageOnlyWarning: Wenn eine Dosierung als reiner Freitext angegeben ist, soll nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
                                                                  DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ))
                                                                  DosageStructuredRequiresGeneratedText: Liegt eine strukturierte Dosierungsangabe vor (timing und doseAndRate belegt, text leer), muss die Extension GeneratedDosageInstructionsMeta vorhanden sein. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(timing.exists() and doseAndRate.exists() and text.empty()) ) implies ( %resource.extension.where( url = 'http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta' ).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).exists() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).exists() ) ))
                                                                  FreeTextSingleDosageOnly: Wenn eine Dosierung als reiner Freitext angegeben ist, darf nur genau ein Dosage-Element existieren. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).exists(text.exists() and timing.empty() and doseAndRate.empty()) ) implies ( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).count() = 1 ))
                                                                  FreeTextMatchesRenderedText: Wenn eine Dosierung als reiner Freitext angegeben ist (text vorhanden, timing und doseAndRate leer) UND die Extension renderedDosageInstruction befüllt ist, muss der Wert in dosageInstruction.text mit dem Wert in der Extension übereinstimmen. (( (%resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where(text.exists() and timing.empty() and doseAndRate.empty()).exists() ) implies ( ( %resource.ofType(MedicationRequest).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationDispense).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationDispense.renderedDosageInstruction' ).value = %resource.dosageInstruction.text ) ) or ( %resource.ofType(MedicationStatement).exists() and ( %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).empty() or %resource.extension.where( url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction' ).value = %resource.dosage.text ) ) ))
                                                                  317. MedicationRequest.dispenseRequest
                                                                  Definition

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

                                                                  ShortMedication supply authorization
                                                                  Control0..1
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  319. 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
                                                                  321. 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())
                                                                  323. 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())
                                                                  325. 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..0
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  332. MedicationRequest.dispenseRequest.dispenseInterval
                                                                  Definition

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

                                                                  ShortMinimum period of time between dispenses
                                                                  Control0..0
                                                                  TypeDuration
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  334. 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..0
                                                                  TypePeriod
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

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

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  336. 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..0
                                                                  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()))
                                                                  338. MedicationRequest.dispenseRequest.quantity
                                                                  Definition

                                                                  The amount that is to be dispensed for one fill.

                                                                  ShortAmount of medication to supply per dispense
                                                                  Control0..1
                                                                  TypeQuantity(SimpleQuantity)
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  340. 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
                                                                  342. 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
                                                                  • 344. 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()))
                                                                    346. 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()))
                                                                    348. 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()))
                                                                    350. 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()))
                                                                    352. 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()))
                                                                    354. 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
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    356. MedicationRequest.dispenseRequest.performer
                                                                    Definition

                                                                    Indicates the intended dispensing Organization specified by the prescriber.

                                                                    ShortIntended dispenser
                                                                    Control0..0
                                                                    TypeReference(Organization)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    358. 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..0
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    365. MedicationRequest.priorPrescription
                                                                    Definition

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

                                                                    ShortAn order/prescription that is being replaced
                                                                    Control0..0
                                                                    TypeReference(MedicationRequest)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    367. 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..0
                                                                    TypeReference(DetectedIssue)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    369. 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..0
                                                                    TypeReference(Provenance)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))