Implementation Guide
TIFlow - Grenzüberschreitender Datenaustausch
Version 2.0.0-ballot.2 - ballot

## Resource Profile: EU-Medication

Official URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-PR-Medication | Version: 2.0.0-ballot.2
Draft as of 2026-06-30 | Computable Name: GEM_ERPEU_PR_Medication

Medication of a Prescription or Dispensation from the EU

Usages:

- Use this Profile: GEM ERP PR EU CloseOperation Input
- Refer to this Profile: Dispensation of the Prescription from the EU
- Examples for this Profile: Medication/Medication-Without-Strength-Code, Medication/Medication-Without-Strength-Numerator, Medication/SimpleMedication and Medication/SumatripanMedication

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Medication |  | 0..* | TIMedicationDgMP | Definition of a Medication Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
meta | S Σ | 0..1 | Meta | Metadata about the resource
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:context | S | 0..1 | code | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension Binding: Context Codes (required)
extension:rxPrescriptionProcessIdentifier | S N | 0..1 | RxPrescriptionProcessIdentifier | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension
extension:isVaccine | S | 0..1 | boolean | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension
extension:drugCategory | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension"
value[x] | S | 1..1 | Coding | Value of extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs (required)
system | S Σ | 1..1 | uri | Identity of the terminology system
code | S Σ | 1..1 | code | Category
extension:normSizeCode | S N | 0..1 | (Complex) | Package size according to N-designation URL: http://fhir.de/StructureDefinition/normgroesse
extension |  | 0..0 |  | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.de/StructureDefinition/normgroesse"
value[x] | S N | 0..1 | code | Value of extension Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE (required)
extension:packaging | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-formulation-packaging-extension
extension:manufacturingInstructions | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-manufacturing-instructions-extension
extension:type | S | 0..1 | Coding | Medication Type URL: https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-medication-type-vs (required)
extension:packageIdentifier |  | 0..1 | Identifier | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
extension:packageDescription |  | 0..1 | string | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier | Σ N | 0..* | Identifier | Business identifier for this medication Slice: Unordered, Open by value:$this
identifier:EPAMedicationUniqueIdentifier | Σ N | 0..1 | EPAMedicationUniqueIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:RxOriginatorProcessIdentifier | Σ N | 0..1 | RxOriginatorProcessIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
code | S Σ | 0..1 | CodeableConcept | Medication in coded form or as free text if necessary Binding: SNOMEDCTMedicationCodes (example): A coded concept that defines the type of a medication.
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:pzn | S Σ N | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
status | ?!S Σ | 0..1 | code | Status of Medication Information Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer | S Σ C | 0..1 | Reference(Organization) | Manufacturer of the Medication Constraints: ref-1
display | S Σ | 1..1 | string | Text alternative for the resource
form | S | 0..1 | CodeableConcept | Form of Dispensing Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
Slices for extension | S | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:dataAbsentReason | S N | 0..1 | code | unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:kbvDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:ifaDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
amount | S Σ C | 0..1 | Ratio | Amount of drug in package Constraints: rat-1
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
Slices for extension |  |  |  | Content/Rules for all slices
extension:packagingSize | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-packaging-size-extension
extension:totalQuantity | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
value | S Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
ingredient | S | 0..* | BackboneElement | Active or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
Slices for extension |  |  |  | Content/Rules for all slices
extension:darreichungsform | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-darreichungsform-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Slices for item[x] | S N | 1..1 |  | The actual ingredient or content Slice: Unordered, Open by type:$this
itemCodeableConcept |  |  | CodeableConcept |
itemReference |  |  | Reference(Substance | Medication) |
item[x]:itemCodeableConcept | S N | 0..1 | CodeableConcept | Encoded description of the substance or component.
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
Slices for coding |  |  |  | Content/Rules for all slices
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:pzn | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
item[x]:itemReference | S N | 0..1 | Reference(Medication) | Restricted EPAMedicationPZNIngredient & EPAMedicationPharmaceuticalProduct only
strength | S C | 0..1 | Ratio | Strength Constraints: rat-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:amountText | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-amount-extension
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
batch | S | 0..1 | BackboneElement | Batch Information
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Medication.extension:drugCategory.​value[x] | Base | required | https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs | Not State | Unknown
Medication.extension:normSizeCode.​value[x] | Base | required | https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE | Not State | Unknown
Medication.code | Base | example | SNOMED CT Medication Codes | 📦4.0.1 | FHIR Std.
Medication.status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
Medication.form | Base | example | SNOMED CT Form Codes | 📦4.0.1 | FHIR Std.
Medication.form.coding:kbvDarreichungsform | Base | required | https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM | Not State | Unknown
Medication.form.coding:ifaDarreichungsform | Base | required | https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM | Not State | Unknown
Medication.amount.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.numerator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.amount.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Medication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Medication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Medication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
qty-3 | error | Medication.amount.numerator, Medication.amount.denominator, Medication.ingredient.strength.numerator, Medication.ingredient.strength.denominator | If a code for the unit is present, the system SHALL also be present | `code.empty() or system.exists()`
rat-1 | error | Medication.amount, Medication.ingredient.strength | Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present | `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())`
ref-1 | error | Medication.manufacturer | 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'))`

This structure is derived from TIMedicationDgMP

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Medication |  | 0..* | TIMedicationDgMP | Definition of a Medication
Slices for extension |  |  |  | Content/Rules for all slices
extension:packageIdentifier |  | 0..1 | Identifier | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
extension:packageDescription |  | 0..1 | string | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Medication |  | 0..* | TIMedicationDgMP | Definition of a Medication Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:context | S | 0..1 | code | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension Binding: Context Codes (required)
extension:rxPrescriptionProcessIdentifier | S N | 0..1 | RxPrescriptionProcessIdentifier | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension
extension:isVaccine | S | 0..1 | boolean | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension
extension:drugCategory | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension"
value[x] | S | 1..1 | Coding | Value of extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs (required)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Category
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
extension:normSizeCode | S N | 0..1 | (Complex) | Package size according to N-designation URL: http://fhir.de/StructureDefinition/normgroesse
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.de/StructureDefinition/normgroesse"
value[x] | S N | 0..1 | code | Value of extension Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE (required)
extension:packaging | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-formulation-packaging-extension
extension:manufacturingInstructions | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-manufacturing-instructions-extension
extension:type | S | 0..1 | Coding | Medication Type URL: https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-medication-type-vs (required)
extension:packageIdentifier |  | 0..1 | Identifier | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
extension:packageDescription |  | 0..1 | string | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier | Σ N | 0..* | Identifier | Business identifier for this medication Slice: Unordered, Open by value:$this
identifier:EPAMedicationUniqueIdentifier | Σ N | 0..1 | EPAMedicationUniqueIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:RxOriginatorProcessIdentifier | Σ N | 0..1 | RxOriginatorProcessIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
code | S Σ | 0..1 | CodeableConcept | Medication in coded form or as free text if necessary Binding: SNOMEDCTMedicationCodes (example): A coded concept that defines the type of a medication.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:pzn | S Σ N | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
status | ?!S Σ | 0..1 | code | Status of Medication Information Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer | S Σ C | 0..1 | Reference(Organization) | Manufacturer of the Medication Constraints: ref-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 1..1 | string | Text alternative for the resource
form | S | 0..1 | CodeableConcept | Form of Dispensing Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension | S | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:dataAbsentReason | S N | 0..1 | code | unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:kbvDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:ifaDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
amount | S Σ C | 0..1 | Ratio | Amount of drug in package Constraints: rat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:packagingSize | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-packaging-size-extension
extension:totalQuantity | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension
value | Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form
code | Σ | 0..1 | code | Coded form of the unit
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
ingredient | S | 0..* | BackboneElement | Active or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:darreichungsform | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-darreichungsform-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Slices for item[x] | S N | 1..1 |  | The actual ingredient or content Slice: Unordered, Open by type:$this
itemCodeableConcept |  |  | CodeableConcept |
itemReference |  |  | Reference(Substance | Medication) |
item[x]:itemCodeableConcept | S N | 0..1 | CodeableConcept | Encoded description of the substance or component.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
Slices for coding |  |  |  | Content/Rules for all slices
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:pzn | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
item[x]:itemReference | S N | 0..1 | Reference(Medication) | Restricted EPAMedicationPZNIngredient & EPAMedicationPharmaceuticalProduct only
isActive |  | 0..1 | boolean | Is it an active ingredient?
strength | S C | 0..1 | Ratio | Strength Constraints: rat-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:amountText | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-amount-extension
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
batch | S | 0..1 | BackboneElement | Batch Information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
lotNumber |  | 0..1 | string | Batch Number
expirationDate |  | 0..1 | dateTime | When batch will expire
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Medication.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
Medication.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std.
Medication.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Medication.extension:drugCategory.​value[x] | Base | required | https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs | Not State | Unknown
Medication.extension:normSizeCode.​value[x] | Base | required | https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE | Not State | Unknown
Medication.code | Base | example | SNOMED CT Medication Codes | 📦4.0.1 | FHIR Std.
Medication.status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
Medication.manufacturer.​type | Base | extensible | ResourceType | 📦4.0.1 | FHIR Std.
Medication.form | Base | example | SNOMED CT Form Codes | 📦4.0.1 | FHIR Std.
Medication.form.coding:kbvDarreichungsform | Base | required | https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM | Not State | Unknown
Medication.form.coding:ifaDarreichungsform | Base | required | https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM | Not State | Unknown
Medication.amount.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.numerator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.amount.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Medication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Medication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Medication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
qty-3 | error | Medication.amount.numerator, Medication.amount.denominator, Medication.ingredient.strength.numerator, Medication.ingredient.strength.denominator | If a code for the unit is present, the system SHALL also be present | `code.empty() or system.exists()`
rat-1 | error | Medication.amount, Medication.ingredient.strength | Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present | `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())`
ref-1 | error | Medication.manufacturer | 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'))`

This structure is derived from TIMedicationDgMP

Summary

Extensions

This structure refers to these extensions:

- https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
- https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Medication |  | 0..* | TIMedicationDgMP | Definition of a Medication Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
meta | S Σ | 0..1 | Meta | Metadata about the resource
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:context | S | 0..1 | code | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension Binding: Context Codes (required)
extension:rxPrescriptionProcessIdentifier | S N | 0..1 | RxPrescriptionProcessIdentifier | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension
extension:isVaccine | S | 0..1 | boolean | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension
extension:drugCategory | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension"
value[x] | S | 1..1 | Coding | Value of extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs (required)
system | S Σ | 1..1 | uri | Identity of the terminology system
code | S Σ | 1..1 | code | Category
extension:normSizeCode | S N | 0..1 | (Complex) | Package size according to N-designation URL: http://fhir.de/StructureDefinition/normgroesse
extension |  | 0..0 |  | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.de/StructureDefinition/normgroesse"
value[x] | S N | 0..1 | code | Value of extension Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE (required)
extension:packaging | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-formulation-packaging-extension
extension:manufacturingInstructions | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-manufacturing-instructions-extension
extension:type | S | 0..1 | Coding | Medication Type URL: https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-medication-type-vs (required)
extension:packageIdentifier |  | 0..1 | Identifier | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
extension:packageDescription |  | 0..1 | string | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier | Σ N | 0..* | Identifier | Business identifier for this medication Slice: Unordered, Open by value:$this
identifier:EPAMedicationUniqueIdentifier | Σ N | 0..1 | EPAMedicationUniqueIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:RxOriginatorProcessIdentifier | Σ N | 0..1 | RxOriginatorProcessIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
code | S Σ | 0..1 | CodeableConcept | Medication in coded form or as free text if necessary Binding: SNOMEDCTMedicationCodes (example): A coded concept that defines the type of a medication.
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:pzn | S Σ N | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
status | ?!S Σ | 0..1 | code | Status of Medication Information Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer | S Σ C | 0..1 | Reference(Organization) | Manufacturer of the Medication Constraints: ref-1
display | S Σ | 1..1 | string | Text alternative for the resource
form | S | 0..1 | CodeableConcept | Form of Dispensing Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
Slices for extension | S | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:dataAbsentReason | S N | 0..1 | code | unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:kbvDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:ifaDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
version |  | 0..1 | string | Version of the system - if relevant
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
amount | S Σ C | 0..1 | Ratio | Amount of drug in package Constraints: rat-1
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
Slices for extension |  |  |  | Content/Rules for all slices
extension:packagingSize | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-packaging-size-extension
extension:totalQuantity | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
value | S Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
ingredient | S | 0..* | BackboneElement | Active or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
Slices for extension |  |  |  | Content/Rules for all slices
extension:darreichungsform | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-darreichungsform-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Slices for item[x] | S N | 1..1 |  | The actual ingredient or content Slice: Unordered, Open by type:$this
itemCodeableConcept |  |  | CodeableConcept |
itemReference |  |  | Reference(Substance | Medication) |
item[x]:itemCodeableConcept | S N | 0..1 | CodeableConcept | Encoded description of the substance or component.
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
Slices for coding |  |  |  | Content/Rules for all slices
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
coding:pzn | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
text | S Σ | 0..1 | string | Plain text representation of the concept
item[x]:itemReference | S N | 0..1 | Reference(Medication) | Restricted EPAMedicationPZNIngredient & EPAMedicationPharmaceuticalProduct only
strength | S C | 0..1 | Ratio | Strength Constraints: rat-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:amountText | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-amount-extension
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
batch | S | 0..1 | BackboneElement | Batch Information
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Medication.extension:drugCategory.​value[x] | Base | required | https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs | Not State | Unknown
Medication.extension:normSizeCode.​value[x] | Base | required | https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE | Not State | Unknown
Medication.code | Base | example | SNOMED CT Medication Codes | 📦4.0.1 | FHIR Std.
Medication.status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
Medication.form | Base | example | SNOMED CT Form Codes | 📦4.0.1 | FHIR Std.
Medication.form.coding:kbvDarreichungsform | Base | required | https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM | Not State | Unknown
Medication.form.coding:ifaDarreichungsform | Base | required | https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM | Not State | Unknown
Medication.amount.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.numerator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.amount.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Medication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Medication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Medication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
qty-3 | error | Medication.amount.numerator, Medication.amount.denominator, Medication.ingredient.strength.numerator, Medication.ingredient.strength.denominator | If a code for the unit is present, the system SHALL also be present | `code.empty() or system.exists()`
rat-1 | error | Medication.amount, Medication.ingredient.strength | Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present | `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())`
ref-1 | error | Medication.manufacturer | 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'))`

Differential View

This structure is derived from TIMedicationDgMP

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Medication |  | 0..* | TIMedicationDgMP | Definition of a Medication
Slices for extension |  |  |  | Content/Rules for all slices
extension:packageIdentifier |  | 0..1 | Identifier | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
extension:packageDescription |  | 0..1 | string | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Medication |  | 0..* | TIMedicationDgMP | Definition of a Medication Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:context | S | 0..1 | code | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension Binding: Context Codes (required)
extension:rxPrescriptionProcessIdentifier | S N | 0..1 | RxPrescriptionProcessIdentifier | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension
extension:isVaccine | S | 0..1 | boolean | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension
extension:drugCategory | S | 0..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension"
value[x] | S | 1..1 | Coding | Value of extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs (required)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Category
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
extension:normSizeCode | S N | 0..1 | (Complex) | Package size according to N-designation URL: http://fhir.de/StructureDefinition/normgroesse
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.de/StructureDefinition/normgroesse"
value[x] | S N | 0..1 | code | Value of extension Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE (required)
extension:packaging | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-formulation-packaging-extension
extension:manufacturingInstructions | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-manufacturing-instructions-extension
extension:type | S | 0..1 | Coding | Medication Type URL: https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension Binding: https://gematik.de/fhir/terminology/ValueSet/ti-medication-type-vs (required)
extension:packageIdentifier |  | 0..1 | Identifier | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
extension:packageDescription |  | 0..1 | string | Extension URL: https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier | Σ N | 0..* | Identifier | Business identifier for this medication Slice: Unordered, Open by value:$this
identifier:EPAMedicationUniqueIdentifier | Σ N | 0..1 | EPAMedicationUniqueIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
identifier:RxOriginatorProcessIdentifier | Σ N | 0..1 | RxOriginatorProcessIdentifier | An identifier intended for computation Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
code | S Σ | 0..1 | CodeableConcept | Medication in coded form or as free text if necessary Binding: SNOMEDCTMedicationCodes (example): A coded concept that defines the type of a medication.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:pzn | S Σ N | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
status | ?!S Σ | 0..1 | code | Status of Medication Information Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
manufacturer | S Σ C | 0..1 | Reference(Organization) | Manufacturer of the Medication Constraints: ref-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | S Σ | 1..1 | string | Text alternative for the resource
form | S | 0..1 | CodeableConcept | Form of Dispensing Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension | S | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:dataAbsentReason | S N | 0..1 | code | unknown | asked | temp | notasked | masked | unsupported | astext | error URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required)
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:kbvDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:ifaDarreichungsform | S Σ N | 0..1 | Coding | Code defined by a terminology system Binding: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM (required) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
amount | S Σ C | 0..1 | Ratio | Amount of drug in package Constraints: rat-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:packagingSize | S N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-packaging-size-extension
extension:totalQuantity | S | 0..1 | string | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension
value | Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | Σ | 0..1 | string | Unit representation
system | Σ C | 0..1 | uri | System that defines coded unit form
code | Σ | 0..1 | code | Coded form of the unit
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 0..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
ingredient | S | 0..* | BackboneElement | Active or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:darreichungsform | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-darreichungsform-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Slices for item[x] | S N | 1..1 |  | The actual ingredient or content Slice: Unordered, Open by type:$this
itemCodeableConcept |  |  | CodeableConcept |
itemReference |  |  | Reference(Substance | Medication) |
item[x]:itemCodeableConcept | S N | 0..1 | CodeableConcept | Encoded description of the substance or component.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | S Σ N | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
Slices for coding |  |  |  | Content/Rules for all slices
coding:ask | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ask
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:atc-de | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/atc
version | Σ | 1..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
coding:pzn | S Σ N | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/ifa/pzn
version | Σ | 0..1 | string | Version of the system - if relevant
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
display | S Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | S Σ | 0..1 | string | Plain text representation of the concept
item[x]:itemReference | S N | 0..1 | Reference(Medication) | Restricted EPAMedicationPZNIngredient & EPAMedicationPharmaceuticalProduct only
isActive |  | 0..1 | boolean | Is it an active ingredient?
strength | S C | 0..1 | Ratio | Strength Constraints: rat-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:amountText | N | 0..1 | string | Optional Extensions Element URL: https://gematik.de/fhir/epa-medication/StructureDefinition/medication-ingredient-amount-extension
numerator | S Σ C | 0..1 | Quantity | Numerator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
denominator | S Σ C | 0..1 | Quantity | Denominator value Binding: UCUMCodes (preferred) Constraints: qty-3
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | S Σ | 1..1 | decimal | Numerical value (with implicit precision)
comparator | ?!Σ | 0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit | S Σ | 0..1 | string | Unit representation
system | S Σ C | 0..1 | uri | System that defines coded unit form
code | S Σ | 0..1 | code | Coded form of the unit
batch | S | 0..1 | BackboneElement | Batch Information
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
lotNumber |  | 0..1 | string | Batch Number
expirationDate |  | 0..1 | dateTime | When batch will expire
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Medication.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
Medication.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std.
Medication.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Medication.extension:drugCategory.​value[x] | Base | required | https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs | Not State | Unknown
Medication.extension:normSizeCode.​value[x] | Base | required | https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE | Not State | Unknown
Medication.code | Base | example | SNOMED CT Medication Codes | 📦4.0.1 | FHIR Std.
Medication.status | Base | required | Medication status codes | 📍4.0.1 | FHIR Std.
Medication.manufacturer.​type | Base | extensible | ResourceType | 📦4.0.1 | FHIR Std.
Medication.form | Base | example | SNOMED CT Form Codes | 📦4.0.1 | FHIR Std.
Medication.form.coding:kbvDarreichungsform | Base | required | https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM | Not State | Unknown
Medication.form.coding:ifaDarreichungsform | Base | required | https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM | Not State | Unknown
Medication.amount.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.numerator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.amount.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.amount.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.numerator.comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator | Base | preferred | UCUM Codes | 📦4.0.1 | FHIR Std.
Medication.ingredient.​strength.denominator.​comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Medication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Medication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Medication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Medication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
qty-3 | error | Medication.amount.numerator, Medication.amount.denominator, Medication.ingredient.strength.numerator, Medication.ingredient.strength.denominator | If a code for the unit is present, the system SHALL also be present | `code.empty() or system.exists()`
rat-1 | error | Medication.amount, Medication.ingredient.strength | Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present | `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())`
ref-1 | error | Medication.manufacturer | 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'))`

This structure is derived from TIMedicationDgMP

Summary

Extensions

This structure refers to these extensions:

- https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageIdentifier
- https://gematik.de/fhir/tiflow-xborder/StructureDefinition/GEM-ERPEU-EX-MedicinalPackageDescription

Other representations of profile: CSV, Excel, Schematron