MII IG Kerndatensatz-Modul Onkologie
2027.0.0-ballot.1 - Germany

This page is part of the MII IG Kerndatensatz-Modul Onkologie (v2027.0.0-ballot.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: MII PR Onkologie Therapieempfehlung Medikation - Detailed Descriptions

Active as of 2026-09-15

Definitions for the mii-pr-onko-therapieempfehlung-medikation 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
Comments

MI-I Medikamentenverordnung

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
Typeidstring
Is Modifierfalse
Must Supporttrue
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.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.


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
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. 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.


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
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. 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()))
12. 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())
14. MedicationRequest.identifier
Definition

Ein Identifikator für die Medikationsverordnung


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.

ShortIdentifikatorExternal 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..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. MedicationRequest.status
Definition

aktiv | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | abgebrochen | Entwurf | unbekannt


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

ShortStatusactive | 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 medicationrequest Statushttp://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

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

Verwenden Sie 'proposal' für eigenständige Therapieempfehlungen. Verwenden Sie 'option' wenn die MedicationRequest Teil einer RequestGroup ist (z.B. Kombinationstherapie).


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

Shortproposal | optionproposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Comments

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

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

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

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

The kind of medication order.

Typecode
Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. 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()))
22. MedicationRequest.medication[x]
Definition

Das Medikament, das verordnet wurde. Code oder Referenz auf Medication-Objekt.


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.

ShortMedikationMedication 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
BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
(example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

A coded concept identifying substance or product that can be ordered.

TypeCodeableConcept, Reference(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()))
SlicingThis element introduces a set of slices on MedicationRequest.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 24. MedicationRequest.medication[x]:medicationCodeableConcept
    Slice NamemedicationCodeableConcept
    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
    BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
    (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

    A coded concept identifying substance or product that can be ordered.

    TypeCodeableConcept, Reference(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()))
    26. MedicationRequest.medication[x]:medicationCodeableConcept.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

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

    Control10..*
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on MedicationRequest.medication[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 28. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer
      Slice NamePharmazentralnummer
      Definition

      Ein Verweis auf einen von der Pharmazentralnummer (PZN) definierten Code


      A reference to a code defined by a terminology system.

      ShortPZN CodeCode defined by a terminology system
      Comments

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

      Control0..*
      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Pattern Value{
        "system" : "http://fhir.de/CodeSystem/ifa/pzn"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.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.

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

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.code
      Definition

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

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

      Need to refer to a particular code in the system.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe
      Slice NameatcClassDe
      Definition

      ATC-Codes für Fertigarzneimittel bspw. von Kombiprodukten


      A reference to a code defined by a terminology system.

      ShortATC Klassifikation deutsche VersionCode defined by a terminology system
      Comments

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

      Control0..*
      BindingThe codes SHALL be taken from For codes, see MII VS Medikation ATC
      (required to https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/ValueSet/mii-vs-medikation-atc)
      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Pattern Value{
        "system" : "http://fhir.de/CodeSystem/bfarm/atc"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.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.

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

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.code
      Definition

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

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

      Need to refer to a particular code in the system.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn
      Slice NameatcClassEn
      Definition

      ATC Classification International WHO Version


      A reference to a code defined by a terminology system.

      ShortAnatomical Therapeutic Chemical Classification SystemCode defined by a terminology system
      Comments

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

      Control0..*
      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Pattern Value{
        "system" : "http://www.whocc.no/atc"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.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.

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

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.code
      Definition

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

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

      Need to refer to a particular code in the system.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII
      Slice NameUNII
      Definition

      Global Susbstance Registration System Unique Ingredient Identifier. Soll nur eingesetzt werden, wenn weder ATC-Code noch PZN existiert, z.B. bei experimentellen Krebsmedikamenten.


      A reference to a code defined by a terminology system.

      ShortUnique Ingredient IdentifierCode defined by a terminology system
      Comments

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

      Control0..*
      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

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

      Pattern Value{
        "system" : "http://fdasis.nlm.nih.gov"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.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.

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

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.code
      Definition

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

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

      Need to refer to a particular code in the system.

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

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

      ShortPlain text representation of the concept
      Comments

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

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

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. MedicationRequest.medication[x]:medicationReference
      Slice NamemedicationReference
      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.

      Control01..1
      TypeReference(MII PR Medikation 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()))
      56. 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()))
      58. MedicationRequest.encounter
      Definition

      Fall oder Kontakt, bei dem die Medikation verordnet wurde.


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

      ShortFall oder KontaktEncounter created as part of encounter/admission/stay
      Comments

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

      Control0..1
      TypeReference(Encounter)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. 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..*
      TypeReference(Resource)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. MedicationRequest.authoredOn
      Definition

      Das Datum und vielleicht die Uhrzeit, an dem die Verordnung ursprünglich verfasst wurde.


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

      ShortDatum der VerordnungWhen 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()))
      64. MedicationRequest.requester
      Definition

      Die Person, Organisation oder das Gerät, die die Verordnung initiiert hat und für deren Aktivierung verantwortlich ist.


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

      ShortAnfordererWho/What requested the Request
      Control0..1
      TypeReference(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()))
      66. MedicationRequest.reasonCode
      Definition

      Grund für die Medikationsverordnung als Code.


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

      ShortGrund CodeReason 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..*
      BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
      (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

      A coded concept indicating why the medication was ordered.

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

      Grund für die Medikationsverordnung als Referenz auf Condition- oder Observation-Objekt.


      Condition or observation that supports why the medication was ordered.

      ShortGrund ReferenzCondition 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.

      Control10..*
      TypeReference(MII PR Onkologie Diagnose Primärtumor, Condition, Observation, Condition, Observation)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      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.reasonReference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ $this.resolve()
      • 70. MedicationRequest.reasonReference:Primaertumor
        Slice NamePrimaertumor
        Definition

        Referenz auf die Primärtumor-Diagnose, auf die sich diese Therapieempfehlung bezieht.


        Condition or observation that supports why the medication was ordered.

        ShortTumorerkrankung (Pflicht)Condition 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.

        Control10..1*
        TypeReference(MII PR Onkologie Diagnose Primärtumor, Condition, Observation)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. MedicationRequest.basedOn
        Definition

        Ein Plan oder eine Anforderung, die ganz oder teilweise durch diese Medikationsverordnung erfüllt wird.


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

        ShortBasiert aufWhat request fulfills
        Control0..*
        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()))
        74. MedicationRequest.note
        Definition

        Zusätzliche Informationen zur Medikationsverordnung als Freitext.


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

        ShortHinweisInformation about the prescription
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. MedicationRequest.dosageInstruction
        Definition

        Gibt an, wie das Medikament vom Patienten zu verwenden ist.


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

        ShortDosierungsanweisungHow 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 DE)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        dsg-1: If present, dosage must include free text or structured data (text.exists() or doseAndRate.exists())
        78. MedicationRequest.dosageInstruction.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

        Control0..*
        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())
        80. MedicationRequest.dosageInstruction.sequence
        Definition

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

        ShortThe order of the dosage instructions
        Control0..1
        Typeinteger
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

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

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

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


        Free text dosage instructions e.g. SIG.

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

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

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

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

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

        Wann das Medikament verabreicht werden soll.


        When medication should be administered.

        ShortWann das Medikament verabreicht werden sollWhen medication should be administered
        Comments

        Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.


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

        Control0..1
        TypeTiming(Timing DE)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

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

        Identifies specific times when the event occurs.

        ShortWhen the event occurs
        Control0..*
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

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

        Eine Menge von Regeln, die beschreiben, wann das Ereignis geplant ist.


        A set of rules that describe when the event is scheduled.

        ShortWann das Ereignis stattfinden sollWhen the event is to occur
        Control0..1
        TypeElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Many timing schedules are determined by regular repetitions.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
        TimingSingleDosageForTimeOfDay: Wenn nur timeOfDay verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
        TimingSingleDosageForWhen: Wenn nur when verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
        TimingBoundsUnitMatchesCode: boundsDuration.unit muss zur UCUM boundsDuration.code passen (z. B. 'Woche(n)' nur mit code='wk'). (bounds.ofType(Duration).exists().not() or ( ( bounds.ofType(Duration).code = 'd' implies ( bounds.ofType(Duration).unit = 'Tag(e)' or bounds.ofType(Duration).unit = 'Tag' or bounds.ofType(Duration).unit = 'Tage' ) ) and ( bounds.ofType(Duration).code = 'wk' implies ( bounds.ofType(Duration).unit = 'Woche(n)' or bounds.ofType(Duration).unit = 'Woche' or bounds.ofType(Duration).unit = 'Wochen' ) ) and ( bounds.ofType(Duration).code = 'mo' implies ( bounds.ofType(Duration).unit = 'Monat(e)' or bounds.ofType(Duration).unit = 'Monat' or bounds.ofType(Duration).unit = 'Monate' ) ) and ( bounds.ofType(Duration).code = 'a' implies ( bounds.ofType(Duration).unit = 'Jahr(e)' or bounds.ofType(Duration).unit = 'Jahr' or bounds.ofType(Duration).unit = 'Jahre' ) ) ))
        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
        92. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
        Definition

        Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.


        Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

        ShortLänge/Bereich der Längen oder (Start- und/oder End-)GrenzenLength/Range of lengths, or (Start and/or end) limits
        Comments

        tbd

        Control0..1
        TypeChoice of: Duration, Range, Period
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        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()))
        SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 94. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration
          Slice NameboundsDuration
          Definition

          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

          ShortDauer der Dosieranweisung ausgedrückt in UCUM-EinheitenLength/Range of lengths, or (Start and/or end) limits
          Control0..1
          TypeDuration, Period, Range
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Pattern Value{
            "system" : "http://unitsofmeasure.org"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value
          Definition

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

          ShortNumerical value (with implicit precision)
          Comments

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

          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()))
          98. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.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..1
          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()))
          100. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.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()))
          102. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system
          Definition

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

          ShortUCUM-Einheit für die DauerSystem that defines coded unit form
          Comments

          Die UCUM-Einheit für die Dauer, z. B. d für Tag, h für Stunde, min für Minute.

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

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

          Fixed Valuehttp://unitsofmeasure.org
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code
          Definition

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

          ShortCoded form of the unit
          Comments

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

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

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange
          Slice NameboundsRange
          Definition

          Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.


          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

          ShortLänge/Bereich der Längen oder (Start- und/oder End-)GrenzenLength/Range of lengths, or (Start and/or end) limits
          Comments

          tbd

          Control0..1
          TypeRange, Period, Duration
          [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()))
          108. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low
          Definition

          The low limit. The boundary is inclusive.

          ShortLow limit
          Comments

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

          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Pattern Value{
            "system" : "http://unitsofmeasure.org"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value
          Definition

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

          ShortNumerical value (with implicit precision)
          Comments

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

          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()))
          112. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.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()))
          114. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.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()))
          116. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system
          Definition

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

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

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code
          Definition

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

          ShortCoded form of the unit
          Comments

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

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

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high
          Definition

          The high limit. The boundary is inclusive.

          ShortHigh limit
          Comments

          If the high element is missing, the high boundary is not known.

          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Pattern Value{
            "system" : "http://unitsofmeasure.org"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value
          Definition

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

          ShortNumerical value (with implicit precision)
          Comments

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

          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()))
          124. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.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()))
          126. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.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()))
          128. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system
          Definition

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

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

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          130. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code
          Definition

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

          ShortCoded form of the unit
          Comments

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

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

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          132. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod
          Slice NameboundsPeriod
          Definition

          Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.


          Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

          ShortLänge/Bereich der Längen oder (Start- und/oder End-)GrenzenLength/Range of lengths, or (Start and/or end) limits
          Comments

          tbd

          Control0..1
          TypePeriod, Duration, Range
          [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()))
          134. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.start
          Definition

          The start of the period. The boundary is inclusive.

          ShortStarting time with inclusive boundary
          Comments

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

          Control0..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          136. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end
          Definition

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

          ShortEnd time with inclusive boundary, if not ongoing
          Comments

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

          Control0..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          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()))
          138. MedicationRequest.dosageInstruction.timing.repeat.count
          Definition

          A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

          ShortNumber of times to repeat
          Comments

          If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

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

          Repetitions may be limited by end time or total occurrences.

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

          If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

          ShortMaximum number of times to repeat
          Control0..1
          TypepositiveInt
          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()))
          142. MedicationRequest.dosageInstruction.timing.repeat.duration
          Definition

          How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

          ShortHow long when it happens
          Comments

          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

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

          Some activities are not instantaneous and need to be maintained for a period of time.

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

          If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

          ShortHow long when it happens (Max)
          Comments

          For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

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

          Some activities are not instantaneous and need to be maintained for a period of time.

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

          The units of time for the duration, in UCUM units.

          Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
          Control0..1
          BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

          A unit of time (units from UCUM).

          Typecode
          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()))
          148. MedicationRequest.dosageInstruction.timing.repeat.frequency
          Definition

          Die Anzahl der Wiederholungen innerhalb des angegebenen Zeitraums. Falls frequencyMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Häufigkeit an.


          The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

          ShortEreignis tritt frequency-mal pro Zeitraum aufEvent occurs frequency times per period
          Control0..1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          150. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
          Definition

          If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

          ShortEvent occurs up to frequencyMax times per period
          Control0..1
          TypepositiveInt
          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()))
          152. MedicationRequest.dosageInstruction.timing.repeat.period
          Definition

          Gibt die Zeitspanne an, über die die Wiederholungen stattfinden sollen; z. B. um „3-mal täglich“ auszudrücken, wäre 3 die Häufigkeit und „1 Tag“ der Zeitraum. Falls periodMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Zeitspanne an.


          Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

          ShortEreignis tritt frequency-mal pro Zeitraum aufEvent occurs frequency times per period
          Control0..1
          Typedecimal
          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()))
          154. MedicationRequest.dosageInstruction.timing.repeat.periodMax
          Definition

          If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

          ShortUpper limit of period (3-4 hours)
          Control0..1
          Typedecimal
          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()))
          156. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
          Definition

          Die Zeiteinheit für den Zeitraum, in UCUM-Einheiten.


          The units of time for the period in UCUM units.

          Shorts | min | h | d | wk | mo | a - Zeiteinheit (UCUM)s | min | h | d | wk | mo | a - unit of time (UCUM)
          Control0..1
          BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
          (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

          A unit of time (units from UCUM).

          Typecode
          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()))
          158. MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek
          Definition

          Wenn ein oder mehrere Wochentage angegeben sind, findet die Aktion nur an den angegebenen Tagen statt.


          If one or more days of week is provided, then the action happens only on the specified day(s).

          Shortmon | tue | wed | thu | fri | sat | sun
          Comments

          Wenn keine Tage angegeben sind, wird angenommen, dass die Aktion an jedem Tag wie sonst angegeben stattfindet.


          If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

          Control0..*
          BindingThe codes SHALL be taken from DaysOfWeekhttp://hl7.org/fhir/ValueSet/days-of-week|4.0.1
          (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
          Typecode
          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()))
          160. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
          Definition

          Angegebene Tageszeit, zu der die Aktion stattfinden soll.


          Specified time of day for action to take place.

          ShortTageszeit für die AktionTime of day for action
          Comments

          Wenn eine Tageszeit angegeben ist, wird angenommen, dass die Aktion jeden Tag (ggf. gefiltert durch dayOfWeek) zu den angegebenen Zeiten stattfindet.


          When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

          Control0..*
          Typetime
          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()))
          162. MedicationRequest.dosageInstruction.timing.repeat.when
          Definition

          Ein ungefährer Zeitraum während des Tages, der möglicherweise mit einem Ereignis des täglichen Lebens verknüpft ist und angibt, wann die Aktion stattfinden soll.


          An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

          ShortCode für den Zeitraum des AuftretensCode for time period of occurrence
          Comments

          Wenn mehr als ein Ereignis angegeben ist, bezieht sich das Ereignis auf die Vereinigung der angegebenen Ereignisse.


          When more than one event is listed, the event is tied to the union of the specified events.

          Control0..*
          BindingThe codes SHALL be taken from EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|4.0.1
          (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

          Real world event relating to the schedule.

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

          Timings are frequently determined by occurrences such as waking, eating and sleep.

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

          The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

          ShortMinutes from event (before or after)
          Control0..1
          TypeunsignedInt
          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()))
          166. MedicationRequest.dosageInstruction.asNeeded[x]
          Definition

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

          ShortTake "as needed" (for x)
          Comments

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

          Control0..1
          BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1
          (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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

          TypeChoice of: boolean, CodeableConcept
          [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
          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()))
          SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.asNeeded[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 168. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean
            Slice NameasNeededBoolean
            Definition

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

            ShortTake "as needed" (for x)
            Comments

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

            Control0..1
            Typeboolean, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            170. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept
            Slice NameasNeededCodeableConcept
            Definition

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

            ShortTake "as needed" (for x)
            Comments

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

            Control0..1
            BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1
            (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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

            TypeCodeableConcept, boolean
            [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()))
            172. MedicationRequest.dosageInstruction.site
            Definition

            Der Ort, an dem das Medikament verabreicht werden soll.


            Body site to administer to.

            ShortVerabreichungsortBody site to administer to
            Comments

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

            Control0..1
            BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

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

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

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

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

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

            Control0..*
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.site.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • pattern @ $this
            • 176. MedicationRequest.dosageInstruction.site.coding:SNOMED
              Slice NameSNOMED
              Definition

              Ein Verweis auf einen von SNOMED CT definierten Code


              A reference to a code defined by a terminology system.

              ShortSNOMED CT CodeCode defined by a terminology system
              Comments

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

              Control0..*
              BindingFor example codes, see For codes, see Body Site - IPS
              (example to http://hl7.org/fhir/uv/ips/ValueSet/body-site-uv-ips)

              target site IPS

              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

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

              Pattern Value{
                "system" : "http://snomed.info/sct"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              178. MedicationRequest.dosageInstruction.site.coding:SNOMED.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.

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

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              180. MedicationRequest.dosageInstruction.site.coding:SNOMED.code
              Definition

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

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

              Need to refer to a particular code in the system.

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

              Der Weg, auf dem das Medikament verabreicht werden soll.


              How drug should enter body.

              ShortVerabreichungswegHow drug should enter body
              Control0..1
              BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
              (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

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

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

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

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

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

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

              Control0..*
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

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

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.route.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • pattern @ $this
              • 186. MedicationRequest.dosageInstruction.route.coding:EDQM
                Slice NameEDQM
                Definition

                Ein Verweis auf einen durch EDQM Standard Terms definierten Code


                A reference to a code defined by a terminology system.

                ShortEDQM CodeCode defined by a terminology system
                Comments

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

                Control0..1*
                BindingThe codes SHOULD be taken from For codes, see Medicine EDQM Route of Administration - IPS
                (preferred to http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration)

                EDQM Standard Terms

                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Pattern Value{
                  "system" : "http://standardterms.edqm.eu"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                188. MedicationRequest.dosageInstruction.route.coding:EDQM.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.

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

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

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

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

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

                Need to refer to a particular code in the system.

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

                Ein Verweis auf einen von SNOMED CT definierten Code


                A reference to a code defined by a terminology system.

                ShortSNOMED CT CodeCode defined by a terminology system
                Comments

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

                Control0..1*
                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Pattern Value{
                  "system" : "http://snomed.info/sct"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                194. MedicationRequest.dosageInstruction.route.coding:SNOMED.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.

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

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

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

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

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

                Need to refer to a particular code in the system.

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

                Die verabreichte Menge des Medikaments.


                The amount of medication administered.

                ShortMenge des verabreichten MedikamentsAmount of medication administered
                Control0..*
                TypeElement
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                200. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
                Definition

                Amount of medication per dose.

                ShortAmount of medication per dose
                Comments

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

                Control0..1
                TypeChoice of: Range, Quantity(SimpleQuantity)
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summarytrue
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 202. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange
                  Slice NamedoseRange
                  Definition

                  Amount of medication per dose.

                  ShortAmount of medication per dose
                  Comments

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

                  Control0..1
                  TypeRange, Quantity(SimpleQuantity)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

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

                  The low limit. The boundary is inclusive.

                  ShortLow limit
                  Comments

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

                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  206. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value
                  Definition

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

                  ShortNumerical value (with implicit precision)
                  Comments

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

                  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()))
                  208. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.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()))
                  210. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.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()))
                  212. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system
                  Definition

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

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

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

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

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

                  ShortCoded form of the unit
                  Comments

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

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

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

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

                  The high limit. The boundary is inclusive.

                  ShortHigh limit
                  Comments

                  If the high element is missing, the high boundary is not known.

                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  218. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value
                  Definition

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

                  ShortNumerical value (with implicit precision)
                  Comments

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

                  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()))
                  220. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.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()))
                  222. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.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()))
                  224. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system
                  Definition

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

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

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

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

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

                  ShortCoded form of the unit
                  Comments

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

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

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

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

                  Menge des Medikaments pro Dosis.


                  Amount of medication per dose.

                  ShortMenge des Medikaments pro DosisAmount of medication per dose
                  Comments

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


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

                  Control0..1
                  BindingThe codes SHALL be taken from For codes, see Dosage DoseQuantity ValueSet
                  (required to http://ig.fhir.de/igs/medication/ValueSet/DosageDoseQuantityDE)
                  TypeQuantity(SimpleQuantity, SimpleQuantity), Range
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

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

                  Amount of medication per unit of time.

                  ShortAmount of medication per unit of time
                  Comments

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

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

                  Control0..1
                  TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summarytrue
                  Requirements

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

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 232. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio
                    Slice NamerateRatio
                    Definition

                    Amount of medication per unit of time.

                    ShortAmount of medication per unit of time
                    Comments

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

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

                    Control0..1
                    TypeRatio, Quantity(SimpleQuantity), Range
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

                    The value of the numerator.

                    ShortNumerator value
                    Control0..1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    236. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.value
                    Definition

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    238. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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..1
                    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()))
                    240. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.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()))
                    242. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.system
                    Definition

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

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

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

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

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

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

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

                    The value of the denominator.

                    ShortDenominator value
                    Control0..1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    248. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.value
                    Definition

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    250. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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..1
                    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()))
                    252. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.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()))
                    254. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.system
                    Definition

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

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

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

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

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

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

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

                    Amount of medication per unit of time.

                    ShortAmount of medication per unit of time
                    Comments

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

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

                    Control0..1
                    TypeRange, Quantity(SimpleQuantity), Ratio
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

                    The low limit. The boundary is inclusive.

                    ShortLow limit
                    Comments

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

                    Control0..1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    262. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.value
                    Definition

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    264. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.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()))
                    266. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.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()))
                    268. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.system
                    Definition

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

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

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

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

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

                    ShortCoded form of the unit
                    Comments

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

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

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

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

                    The high limit. The boundary is inclusive.

                    ShortHigh limit
                    Comments

                    If the high element is missing, the high boundary is not known.

                    Control0..1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    274. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.value
                    Definition

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    276. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.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()))
                    278. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.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()))
                    280. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.system
                    Definition

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

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

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

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

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

                    ShortCoded form of the unit
                    Comments

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

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

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

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

                    Amount of medication per unit of time.

                    ShortAmount of medication per unit of time
                    Comments

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

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

                    Control0..1
                    TypeQuantity(SimpleQuantity), Ratio, Range
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    288. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.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()))
                    290. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.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()))
                    292. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.system
                    Definition

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

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

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

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

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

                    ShortCoded form of the unit
                    Comments

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

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

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

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

                    Upper limit on medication per unit of time.

                    ShortUpper limit on medication per unit of time
                    Comments

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

                    Control0..1
                    TypeRatio
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

                    The value of the numerator.

                    ShortNumerator value
                    Control0..1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    300. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value
                    Definition

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    302. MedicationRequest.dosageInstruction.maxDosePerPeriod.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..1
                    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()))
                    304. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.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()))
                    306. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system
                    Definition

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

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

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

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

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

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

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

                    The value of the denominator.

                    ShortDenominator value
                    Control0..1
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    312. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value
                    Definition

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    314. MedicationRequest.dosageInstruction.maxDosePerPeriod.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..1
                    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()))
                    316. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.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()))
                    318. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system
                    Definition

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

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

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

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

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

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

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

                    Upper limit on medication per administration.

                    ShortUpper limit on medication per administration
                    Comments

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

                    Control0..1
                    TypeQuantity(SimpleQuantity)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

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

                    ShortNumerical value (with implicit precision)
                    Comments

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

                    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()))
                    326. MedicationRequest.dosageInstruction.maxDosePerAdministration.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()))
                    328. MedicationRequest.dosageInstruction.maxDosePerAdministration.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()))
                    330. MedicationRequest.dosageInstruction.maxDosePerAdministration.system
                    Definition

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

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

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

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

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

                    ShortCoded form of the unit
                    Comments

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

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

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

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

                    Etwaige Einschränkungen bei der Substitution von Medikamenten


                    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.

                    ShortSubstitutionAny restrictions on medication substitution
                    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()))
                    336. MedicationRequest.substitution.modifierExtension
                    Definition

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

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

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

                    ShortWhether substitution is allowed or not
                    Comments

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

                    Control1..1
                    BindingFor example codes, see ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
                    (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                    Identifies the type of substitution allowed.

                    TypeChoice of: boolean, CodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    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.substitution.allowed[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 340. MedicationRequest.substitution.allowed[x]:allowedBoolean
                      Slice NameallowedBoolean
                      Definition

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

                      ShortWhether substitution is allowed or not
                      Comments

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

                      Control01..1
                      Typeboolean, CodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      342. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept
                      Slice NameallowedCodeableConcept
                      Definition

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

                      ShortWhether substitution is allowed or not
                      Comments

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

                      Control01..1
                      BindingFor example codes, see ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
                      (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                      Identifies the type of substitution allowed.

                      TypeCodeableConcept, boolean
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      344. MedicationRequest.priorPrescription
                      Definition

                      Eine Verschreibung, die ersetzt wird


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

                      ShortVorherige VerschreibungAn order/prescription that is being replaced
                      Control0..1
                      TypeReference(MedicationRequest)
                      Is Modifierfalse
                      Must Supporttrue
                      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.intent
                      Definition

                      Verwenden Sie 'proposal' für eigenständige Therapieempfehlungen. Verwenden Sie 'option' wenn die MedicationRequest Teil einer RequestGroup ist (z.B. Kombinationstherapie).

                      Shortproposal | option
                      4. MedicationRequest.medication[x]:medicationCodeableConcept
                      Slice NamemedicationCodeableConcept
                      Control1..?
                      TypeCodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      6. MedicationRequest.medication[x]:medicationCodeableConcept.coding
                      Control1..?
                      8. MedicationRequest.subject
                      TypeReference(Patient)
                      10. MedicationRequest.supportingInformation
                      Must Supporttrue
                      12. MedicationRequest.authoredOn
                      Control1..?
                      14. MedicationRequest.reasonReference
                      Control1..?
                      TypeReference(MII PR Onkologie Diagnose Primärtumor, Condition, Observation)
                      SlicingThis element introduces a set of slices on MedicationRequest.reasonReference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • profile @ $this.resolve()
                      • 16. MedicationRequest.reasonReference:Primaertumor
                        Slice NamePrimaertumor
                        Definition

                        Referenz auf die Primärtumor-Diagnose, auf die sich diese Therapieempfehlung bezieht.

                        ShortTumorerkrankung (Pflicht)
                        Control1..1
                        TypeReference(MII PR Onkologie Diagnose Primärtumor)
                        Must Supporttrue

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

                        0. MedicationRequest
                        Definition

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

                        ShortOrdering of medication for patient or group
                        Comments

                        MI-I Medikamentenverordnung

                        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
                        Must Supporttrue
                        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
                          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
                          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
                          Must Supporttrue
                          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
                          Must Supporttrue
                          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|4.0.1)

                          Security Labels from the Healthcare Privacy and Security Classification System.

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

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

                          ShortTags applied to this resource
                          Comments

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

                          Control0..*
                          BindingFor example codes, see CommonTags
                          (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

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

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

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

                          ShortA set of rules under which this content was created
                          Comments

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

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

                          The base language in which the resource is written.

                          ShortLanguage of the resource content
                          Comments

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

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

                          A human language.

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

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

                          ShortText summary of the resource, for human interpretation
                          Comments

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

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

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

                          ShortContained, inline Resources
                          Comments

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          32. 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())
                          34. MedicationRequest.identifier
                          Definition

                          Ein Identifikator für die Medikationsverordnung

                          ShortIdentifikator
                          Comments

                          This is a business identifier, not a resource identifier.

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          36. MedicationRequest.status
                          Definition

                          aktiv | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | abgebrochen | Entwurf | unbekannt

                          ShortStatus
                          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 medicationrequest Status
                          (required to http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1)

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

                          Captures the reason for the current state of the MedicationRequest.

                          ShortReason for current status
                          Comments

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

                          Control0..1
                          BindingFor example codes, see medicationRequest Status Reason Codes
                          (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason|4.0.1)

                          Identifies the reasons for a given status.

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

                          Verwenden Sie 'proposal' für eigenständige Therapieempfehlungen. Verwenden Sie 'option' wenn die MedicationRequest Teil einer RequestGroup ist (z.B. Kombinationstherapie).

                          Shortproposal | 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 Intent
                          (required to http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1)

                          The kind of medication order.

                          Typecode
                          Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          42. 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..*
                          BindingFor example codes, see medicationRequest Category Codes
                          (example to http://hl7.org/fhir/ValueSet/medicationrequest-category|4.0.1)

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

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

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

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

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

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          46. 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()))
                          48. MedicationRequest.reported[x]
                          Definition

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

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

                          Das Medikament, das verordnet wurde. Code oder Referenz auf Medication-Objekt.

                          ShortMedikation
                          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
                          BindingFor example codes, see SNOMEDCTMedicationCodes
                          (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                          A coded concept identifying substance or product that can be ordered.

                          TypeCodeableConcept
                          [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()))
                          SlicingThis element introduces a set of slices on MedicationRequest.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 52. MedicationRequest.medication[x]:medicationCodeableConcept
                            Slice NamemedicationCodeableConcept
                            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
                            BindingFor example codes, see SNOMEDCTMedicationCodes
                            (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                            A coded concept identifying substance or product that can be ordered.

                            TypeCodeableConcept
                            [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()))
                            54. MedicationRequest.medication[x]:medicationCodeableConcept.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
                            56. MedicationRequest.medication[x]:medicationCodeableConcept.extension
                            Definition

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

                              A reference to a code defined by a terminology system.

                              ShortCode defined by a terminology system
                              Comments

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

                              Control1..*
                              TypeCoding
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on MedicationRequest.medication[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • pattern @ $this
                              • 60. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer
                                Slice NamePharmazentralnummer
                                Definition

                                Ein Verweis auf einen von der Pharmazentralnummer (PZN) definierten Code

                                ShortPZN Code
                                Comments

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

                                Control0..*
                                TypeCoding
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Requirements

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

                                Pattern Value{
                                  "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                62. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.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
                                64. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

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

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  68. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.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()))
                                  70. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.code
                                  Definition

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

                                  ShortSymbol in syntax defined by the system
                                  Control1..1
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

                                  Need to refer to a particular code in the system.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  72. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.display
                                  Definition

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

                                  ShortRepresentation defined by the system
                                  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()))
                                  74. MedicationRequest.medication[x]:medicationCodeableConcept.coding:Pharmazentralnummer.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()))
                                  76. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe
                                  Slice NameatcClassDe
                                  Definition

                                  ATC-Codes für Fertigarzneimittel bspw. von Kombiprodukten

                                  ShortATC Klassifikation deutsche Version
                                  Comments

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

                                  Control0..*
                                  BindingThe codes SHALL be taken from MII VS Medikation ATC
                                  (required to https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/ValueSet/mii-vs-medikation-atc)
                                  TypeCoding
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Requirements

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

                                  Pattern Value{
                                    "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  78. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.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
                                  80. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.extension
                                  Definition

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

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

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

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    84. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.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()))
                                    86. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.code
                                    Definition

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

                                    ShortSymbol in syntax defined by the system
                                    Control1..1
                                    Typecode
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Need to refer to a particular code in the system.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    88. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.display
                                    Definition

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

                                    ShortRepresentation defined by the system
                                    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()))
                                    90. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassDe.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()))
                                    92. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn
                                    Slice NameatcClassEn
                                    Definition

                                    ATC Classification International WHO Version

                                    ShortAnatomical Therapeutic Chemical Classification System
                                    Comments

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

                                    Control0..*
                                    TypeCoding
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

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

                                    Pattern Value{
                                      "system" : "http://www.whocc.no/atc"
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    94. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.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
                                    96. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.extension
                                    Definition

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

                                    ShortAdditional content defined by implementations
                                    Comments

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

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

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

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

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      100. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.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()))
                                      102. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.code
                                      Definition

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

                                      ShortSymbol in syntax defined by the system
                                      Control1..1
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Need to refer to a particular code in the system.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      104. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.display
                                      Definition

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

                                      ShortRepresentation defined by the system
                                      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()))
                                      106. MedicationRequest.medication[x]:medicationCodeableConcept.coding:atcClassEn.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()))
                                      108. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII
                                      Slice NameUNII
                                      Definition

                                      Global Susbstance Registration System Unique Ingredient Identifier. Soll nur eingesetzt werden, wenn weder ATC-Code noch PZN existiert, z.B. bei experimentellen Krebsmedikamenten.

                                      ShortUnique Ingredient Identifier
                                      Comments

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

                                      Control0..*
                                      TypeCoding
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

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

                                      Pattern Value{
                                        "system" : "http://fdasis.nlm.nih.gov"
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      110. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.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
                                      112. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.extension
                                      Definition

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

                                      ShortAdditional content defined by implementations
                                      Comments

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

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

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

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

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        116. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.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()))
                                        118. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.code
                                        Definition

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

                                        ShortSymbol in syntax defined by the system
                                        Control1..1
                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to refer to a particular code in the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        120. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.display
                                        Definition

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

                                        ShortRepresentation defined by the system
                                        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()))
                                        122. MedicationRequest.medication[x]:medicationCodeableConcept.coding:UNII.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()))
                                        124. MedicationRequest.medication[x]:medicationCodeableConcept.text
                                        Definition

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

                                        ShortPlain text representation of the concept
                                        Comments

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

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

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

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        126. MedicationRequest.medication[x]:medicationReference
                                        Slice NamemedicationReference
                                        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.

                                        Control0..1
                                        TypeReference(MII PR Medikation 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()))
                                        128. 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()))
                                        130. MedicationRequest.encounter
                                        Definition

                                        Fall oder Kontakt, bei dem die Medikation verordnet wurde.

                                        ShortFall oder Kontakt
                                        Comments

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

                                        Control0..1
                                        TypeReference(Encounter)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        132. 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..*
                                        TypeReference(Resource)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        134. MedicationRequest.authoredOn
                                        Definition

                                        Das Datum und vielleicht die Uhrzeit, an dem die Verordnung ursprünglich verfasst wurde.

                                        ShortDatum der Verordnung
                                        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()))
                                        136. MedicationRequest.requester
                                        Definition

                                        Die Person, Organisation oder das Gerät, die die Verordnung initiiert hat und für deren Aktivierung verantwortlich ist.

                                        ShortAnforderer
                                        Control0..1
                                        TypeReference(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()))
                                        138. MedicationRequest.performer
                                        Definition

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

                                        ShortIntended performer of administration
                                        Control0..1
                                        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()))
                                        140. MedicationRequest.performerType
                                        Definition

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

                                        ShortDesired kind of performer of the medication administration
                                        Comments

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

                                        Control0..1
                                        BindingFor example codes, see ProcedurePerformerRoleCodes
                                        (example to http://hl7.org/fhir/ValueSet/performer-role|4.0.1)

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

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

                                        Die Person, die den Auftrag im Namen einer anderen Person eingegeben hat, zum Beispiel im Fall eines mündlichen oder telefonischen Auftrags.

                                        ShortAuftragserfasser
                                        Control0..1
                                        TypeReference(Practitioner, PractitionerRole)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        144. MedicationRequest.reasonCode
                                        Definition

                                        Grund für die Medikationsverordnung als Code.

                                        ShortGrund Code
                                        Comments

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

                                        Control0..*
                                        BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                        (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                        A coded concept indicating why the medication was ordered.

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

                                        Grund für die Medikationsverordnung als Referenz auf Condition- oder Observation-Objekt.

                                        ShortGrund Referenz
                                        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.

                                        Control1..*
                                        TypeReference(MII PR Onkologie Diagnose Primärtumor, Condition, Observation)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        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.reasonReference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • profile @ $this.resolve()
                                        • 148. MedicationRequest.reasonReference:Primaertumor
                                          Slice NamePrimaertumor
                                          Definition

                                          Referenz auf die Primärtumor-Diagnose, auf die sich diese Therapieempfehlung bezieht.

                                          ShortTumorerkrankung (Pflicht)
                                          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.

                                          Control1..1
                                          TypeReference(MII PR Onkologie Diagnose Primärtumor)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          150. 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..*
                                          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()))
                                          152. 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..*
                                          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()))
                                          154. MedicationRequest.basedOn
                                          Definition

                                          Ein Plan oder eine Anforderung, die ganz oder teilweise durch diese Medikationsverordnung erfüllt wird.

                                          ShortBasiert auf
                                          Control0..*
                                          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()))
                                          156. MedicationRequest.groupIdentifier
                                          Definition

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

                                          ShortComposite request this is part of
                                          Control0..1
                                          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()))
                                          158. MedicationRequest.courseOfTherapyType
                                          Definition

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

                                          ShortOverall pattern of medication administration
                                          Comments

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

                                          Control0..1
                                          BindingFor example codes, see medicationRequest Course of Therapy Codes
                                          (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy|4.0.1)

                                          Identifies the overall pattern of medication administratio.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          160. 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..*
                                          TypeReference(Coverage, ClaimResponse)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          162. MedicationRequest.note
                                          Definition

                                          Zusätzliche Informationen zur Medikationsverordnung als Freitext.

                                          ShortHinweis
                                          Control0..*
                                          TypeAnnotation
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          164. MedicationRequest.dosageInstruction
                                          Definition

                                          Gibt an, wie das Medikament vom Patienten zu verwenden ist.

                                          ShortDosierungsanweisung
                                          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 DE)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          dsg-1: If present, dosage must include free text or structured data (text.exists() or doseAndRate.exists())
                                          166. MedicationRequest.dosageInstruction.id
                                          Definition

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

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

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

                                            Control0..*
                                            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())
                                            172. MedicationRequest.dosageInstruction.sequence
                                            Definition

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

                                            ShortThe order of the dosage instructions
                                            Control0..1
                                            Typeinteger
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

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

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

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

                                            ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Stück bei Bedarf'
                                            Comments

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

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

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

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

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

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

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

                                            Control0..*
                                            BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                            (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

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

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

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

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

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

                                            ShortPatient or consumer oriented instructions
                                            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()))
                                            180. MedicationRequest.dosageInstruction.timing
                                            Definition

                                            Wann das Medikament verabreicht werden soll.

                                            ShortWann das Medikament verabreicht werden soll
                                            Comments

                                            Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructionsMeta Extension zu verwenden.

                                            Control0..1
                                            TypeTiming(Timing DE)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

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

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

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

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

                                              Identifies specific times when the event occurs.

                                              ShortWhen the event occurs
                                              Control0..*
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summarytrue
                                              Requirements

                                              In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

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

                                              Eine Menge von Regeln, die beschreiben, wann das Ereignis geplant ist.

                                              ShortWann das Ereignis stattfinden soll
                                              Control0..1
                                              TypeElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summarytrue
                                              Requirements

                                              Many timing schedules are determined by regular repetitions.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                                              tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                                              tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                                              tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                                              tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                                              tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                                              tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                                              tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
                                              tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                                              TimingSingleDosageForTimeOfDay: Wenn nur timeOfDay verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.timeOfDay.exists() and timing.repeat.when.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
                                              TimingSingleDosageForWhen: Wenn nur when verwendet wird und täglich dosiert wird, ist die Angabe in einem einzigen Dosage-Element zu modellieren. Mehrere Dosage-Elemente sind nur zulässig, wenn sich die Dosis (Wert) unterscheidet. (( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).all( ( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ) implies ( ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).count() = 1 ) or ( ( %resource.ofType(MedicationRequest).dosageInstruction | %resource.ofType(MedicationDispense).dosageInstruction | %resource.ofType(MedicationStatement).dosage ).where( timing.repeat.dayOfWeek.empty() and timing.repeat.when.exists() and timing.repeat.timeOfDay.empty() and (timing.repeat.period.exists() and timing.repeat.period = 1) and (timing.repeat.periodUnit.exists() and timing.repeat.periodUnit = 'd') ).doseAndRate.dose.ofType(Quantity).value.distinct().count() > 1 ) ) ))
                                              TimingBoundsUnitMatchesCode: boundsDuration.unit muss zur UCUM boundsDuration.code passen (z. B. 'Woche(n)' nur mit code='wk'). (bounds.ofType(Duration).exists().not() or ( ( bounds.ofType(Duration).code = 'd' implies ( bounds.ofType(Duration).unit = 'Tag(e)' or bounds.ofType(Duration).unit = 'Tag' or bounds.ofType(Duration).unit = 'Tage' ) ) and ( bounds.ofType(Duration).code = 'wk' implies ( bounds.ofType(Duration).unit = 'Woche(n)' or bounds.ofType(Duration).unit = 'Woche' or bounds.ofType(Duration).unit = 'Wochen' ) ) and ( bounds.ofType(Duration).code = 'mo' implies ( bounds.ofType(Duration).unit = 'Monat(e)' or bounds.ofType(Duration).unit = 'Monat' or bounds.ofType(Duration).unit = 'Monate' ) ) and ( bounds.ofType(Duration).code = 'a' implies ( bounds.ofType(Duration).unit = 'Jahr(e)' or bounds.ofType(Duration).unit = 'Jahr' or bounds.ofType(Duration).unit = 'Jahre' ) ) ))
                                              192. MedicationRequest.dosageInstruction.timing.repeat.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.dosageInstruction.timing.repeat.extension
                                              Definition

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

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

                                                Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.

                                                ShortLänge/Bereich der Längen oder (Start- und/oder End-)Grenzen
                                                Comments

                                                tbd

                                                Control0..1
                                                TypeChoice of: Duration, Range, Period
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                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()))
                                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.bounds[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 198. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration
                                                  Slice NameboundsDuration
                                                  Definition

                                                  Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                                  ShortDauer der Dosieranweisung ausgedrückt in UCUM-Einheiten
                                                  Control0..1
                                                  TypeDuration
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Pattern Value{
                                                    "system" : "http://unitsofmeasure.org"
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  200. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.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
                                                  202. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension
                                                  Definition

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

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

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

                                                    ShortNumerical value (with implicit precision)
                                                    Comments

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

                                                    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()))
                                                    206. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.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..1
                                                    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()))
                                                    208. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.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()))
                                                    210. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system
                                                    Definition

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

                                                    ShortUCUM-Einheit für die Dauer
                                                    Comments

                                                    Die UCUM-Einheit für die Dauer, z. B. d für Tag, h für Stunde, min für Minute.

                                                    Control1..1
                                                    This element is affected by the following invariants: qty-3
                                                    Typeuri
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summarytrue
                                                    Requirements

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

                                                    Fixed Valuehttp://unitsofmeasure.org
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    212. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code
                                                    Definition

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

                                                    ShortCoded form of the unit
                                                    Comments

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

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

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

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    214. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange
                                                    Slice NameboundsRange
                                                    Definition

                                                    Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.

                                                    ShortLänge/Bereich der Längen oder (Start- und/oder End-)Grenzen
                                                    Comments

                                                    tbd

                                                    Control0..1
                                                    TypeRange
                                                    [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()))
                                                    216. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    218. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension
                                                    Definition

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

                                                    ShortAdditional content defined by implementations
                                                    Comments

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

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

                                                      The low limit. The boundary is inclusive.

                                                      ShortLow limit
                                                      Comments

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

                                                      Control0..1
                                                      TypeQuantity(SimpleQuantity)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Pattern Value{
                                                        "system" : "http://unitsofmeasure.org"
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      222. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.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
                                                      224. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension
                                                      Definition

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

                                                      ShortAdditional content defined by implementations
                                                      Comments

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

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

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

                                                        ShortNumerical value (with implicit precision)
                                                        Comments

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

                                                        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()))
                                                        228. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.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()))
                                                        230. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.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()))
                                                        232. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system
                                                        Definition

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

                                                        ShortSystem that defines coded unit form
                                                        Control1..1
                                                        This element is affected by the following invariants: qty-3
                                                        Typeuri
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

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

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        234. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code
                                                        Definition

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

                                                        ShortCoded form of the unit
                                                        Comments

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

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

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

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        236. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high
                                                        Definition

                                                        The high limit. The boundary is inclusive.

                                                        ShortHigh limit
                                                        Comments

                                                        If the high element is missing, the high boundary is not known.

                                                        Control0..1
                                                        TypeQuantity(SimpleQuantity)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Pattern Value{
                                                          "system" : "http://unitsofmeasure.org"
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        238. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.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
                                                        240. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension
                                                        Definition

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

                                                        ShortAdditional content defined by implementations
                                                        Comments

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

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

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

                                                          ShortNumerical value (with implicit precision)
                                                          Comments

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

                                                          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()))
                                                          244. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.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()))
                                                          246. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.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.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system
                                                          Definition

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

                                                          ShortSystem that defines coded unit form
                                                          Control1..1
                                                          This element is affected by the following invariants: qty-3
                                                          Typeuri
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

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

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          250. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code
                                                          Definition

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

                                                          ShortCoded form of the unit
                                                          Comments

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

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

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

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          252. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod
                                                          Slice NameboundsPeriod
                                                          Definition

                                                          Entweder eine Dauer für die Länge des Zeitplans, ein Bereich möglicher Längen oder äußere Begrenzungen für Start- und/oder Endgrenzen des Zeitplans.

                                                          ShortLänge/Bereich der Längen oder (Start- und/oder End-)Grenzen
                                                          Comments

                                                          tbd

                                                          Control0..1
                                                          TypePeriod
                                                          [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()))
                                                          254. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.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
                                                          256. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.extension
                                                          Definition

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

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

                                                            The start of the period. The boundary is inclusive.

                                                            ShortStarting time with inclusive boundary
                                                            Comments

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

                                                            Control0..1
                                                            This element is affected by the following invariants: per-1
                                                            TypedateTime
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            260. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]:boundsPeriod.end
                                                            Definition

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

                                                            ShortEnd time with inclusive boundary, if not ongoing
                                                            Comments

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

                                                            Control0..1
                                                            This element is affected by the following invariants: per-1
                                                            TypedateTime
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            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()))
                                                            262. MedicationRequest.dosageInstruction.timing.repeat.count
                                                            Definition

                                                            A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

                                                            ShortNumber of times to repeat
                                                            Comments

                                                            If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

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

                                                            Repetitions may be limited by end time or total occurrences.

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

                                                            If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                                                            ShortMaximum number of times to repeat
                                                            Control0..1
                                                            TypepositiveInt
                                                            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()))
                                                            266. MedicationRequest.dosageInstruction.timing.repeat.duration
                                                            Definition

                                                            How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

                                                            ShortHow long when it happens
                                                            Comments

                                                            For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

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

                                                            Some activities are not instantaneous and need to be maintained for a period of time.

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

                                                            If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                                                            ShortHow long when it happens (Max)
                                                            Comments

                                                            For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

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

                                                            Some activities are not instantaneous and need to be maintained for a period of time.

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

                                                            The units of time for the duration, in UCUM units.

                                                            Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                                                            Control0..1
                                                            BindingThe codes SHALL be taken from UnitsOfTime
                                                            (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                                            A unit of time (units from UCUM).

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

                                                            Die Anzahl der Wiederholungen innerhalb des angegebenen Zeitraums. Falls frequencyMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Häufigkeit an.

                                                            ShortEreignis tritt frequency-mal pro Zeitraum auf
                                                            Control0..1
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            274. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
                                                            Definition

                                                            If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                                                            ShortEvent occurs up to frequencyMax times per period
                                                            Control0..1
                                                            TypepositiveInt
                                                            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()))
                                                            276. MedicationRequest.dosageInstruction.timing.repeat.period
                                                            Definition

                                                            Gibt die Zeitspanne an, über die die Wiederholungen stattfinden sollen; z. B. um „3-mal täglich“ auszudrücken, wäre 3 die Häufigkeit und „1 Tag“ der Zeitraum. Falls periodMax vorhanden ist, gibt dieses Element die Untergrenze des zulässigen Bereichs der Zeitspanne an.

                                                            ShortEreignis tritt frequency-mal pro Zeitraum auf
                                                            Control0..1
                                                            Typedecimal
                                                            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.dosageInstruction.timing.repeat.periodMax
                                                            Definition

                                                            If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                                                            ShortUpper limit of period (3-4 hours)
                                                            Control0..1
                                                            Typedecimal
                                                            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()))
                                                            280. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
                                                            Definition

                                                            Die Zeiteinheit für den Zeitraum, in UCUM-Einheiten.

                                                            Shorts | min | h | d | wk | mo | a - Zeiteinheit (UCUM)
                                                            Control0..1
                                                            BindingThe codes SHALL be taken from UnitsOfTime
                                                            (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                                            A unit of time (units from UCUM).

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

                                                            Wenn ein oder mehrere Wochentage angegeben sind, findet die Aktion nur an den angegebenen Tagen statt.

                                                            Shortmon | tue | wed | thu | fri | sat | sun
                                                            Comments

                                                            Wenn keine Tage angegeben sind, wird angenommen, dass die Aktion an jedem Tag wie sonst angegeben stattfindet.

                                                            Control0..*
                                                            BindingThe codes SHALL be taken from DaysOfWeek
                                                            (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                                                            Typecode
                                                            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()))
                                                            284. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
                                                            Definition

                                                            Angegebene Tageszeit, zu der die Aktion stattfinden soll.

                                                            ShortTageszeit für die Aktion
                                                            Comments

                                                            Wenn eine Tageszeit angegeben ist, wird angenommen, dass die Aktion jeden Tag (ggf. gefiltert durch dayOfWeek) zu den angegebenen Zeiten stattfindet.

                                                            Control0..*
                                                            Typetime
                                                            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()))
                                                            286. MedicationRequest.dosageInstruction.timing.repeat.when
                                                            Definition

                                                            Ein ungefährer Zeitraum während des Tages, der möglicherweise mit einem Ereignis des täglichen Lebens verknüpft ist und angibt, wann die Aktion stattfinden soll.

                                                            ShortCode für den Zeitraum des Auftretens
                                                            Comments

                                                            Wenn mehr als ein Ereignis angegeben ist, bezieht sich das Ereignis auf die Vereinigung der angegebenen Ereignisse.

                                                            Control0..*
                                                            BindingThe codes SHALL be taken from EventTiming
                                                            (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

                                                            Real world event relating to the schedule.

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

                                                            Timings are frequently determined by occurrences such as waking, eating and sleep.

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

                                                            The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

                                                            ShortMinutes from event (before or after)
                                                            Control0..1
                                                            TypeunsignedInt
                                                            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()))
                                                            290. MedicationRequest.dosageInstruction.timing.code
                                                            Definition

                                                            A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

                                                            ShortBID | TID | QID | AM | PM | QD | QOD | +
                                                            Comments

                                                            BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

                                                            Control0..1
                                                            BindingThe codes SHOULD be taken from TimingAbbreviation
                                                            (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1)

                                                            Code for a known / defined timing pattern.

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

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

                                                            ShortTake "as needed" (for x)
                                                            Comments

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

                                                            Control0..1
                                                            BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                                            (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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

                                                            TypeChoice of: boolean, CodeableConcept
                                                            [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
                                                            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()))
                                                            SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.asNeeded[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                            • type @ $this
                                                            • 294. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededBoolean
                                                              Slice NameasNeededBoolean
                                                              Definition

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

                                                              ShortTake "as needed" (for x)
                                                              Comments

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

                                                              Control0..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
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              296. MedicationRequest.dosageInstruction.asNeeded[x]:asNeededCodeableConcept
                                                              Slice NameasNeededCodeableConcept
                                                              Definition

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

                                                              ShortTake "as needed" (for x)
                                                              Comments

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

                                                              Control0..1
                                                              BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                                              (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

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

                                                              TypeCodeableConcept
                                                              [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()))
                                                              298. MedicationRequest.dosageInstruction.site
                                                              Definition

                                                              Der Ort, an dem das Medikament verabreicht werden soll.

                                                              ShortVerabreichungsort
                                                              Comments

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

                                                              Control0..1
                                                              BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                                              (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

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

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summarytrue
                                                              Requirements

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

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

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

                                                              ShortAdditional content defined by implementations
                                                              Comments

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

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

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

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

                                                                Control0..*
                                                                TypeCoding
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Requirements

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

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.site.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • pattern @ $this
                                                                • 306. MedicationRequest.dosageInstruction.site.coding:SNOMED
                                                                  Slice NameSNOMED
                                                                  Definition

                                                                  Ein Verweis auf einen von SNOMED CT definierten Code

                                                                  ShortSNOMED CT Code
                                                                  Comments

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

                                                                  Control0..*
                                                                  BindingFor example codes, see Body Site - IPS
                                                                  (example to http://hl7.org/fhir/uv/ips/ValueSet/body-site-uv-ips)

                                                                  target site IPS

                                                                  TypeCoding
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Requirements

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

                                                                  Pattern Value{
                                                                    "system" : "http://snomed.info/sct"
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  308. MedicationRequest.dosageInstruction.site.coding:SNOMED.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
                                                                  310. MedicationRequest.dosageInstruction.site.coding:SNOMED.extension
                                                                  Definition

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

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

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

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

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

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

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    314. MedicationRequest.dosageInstruction.site.coding:SNOMED.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()))
                                                                    316. MedicationRequest.dosageInstruction.site.coding:SNOMED.code
                                                                    Definition

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

                                                                    ShortSymbol in syntax defined by the system
                                                                    Control1..1
                                                                    Typecode
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Requirements

                                                                    Need to refer to a particular code in the system.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    318. MedicationRequest.dosageInstruction.site.coding:SNOMED.display
                                                                    Definition

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

                                                                    ShortRepresentation defined by the system
                                                                    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()))
                                                                    320. MedicationRequest.dosageInstruction.site.coding:SNOMED.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()))
                                                                    322. MedicationRequest.dosageInstruction.site.text
                                                                    Definition

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

                                                                    ShortPlain text representation of the concept
                                                                    Comments

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

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

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

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

                                                                    Der Weg, auf dem das Medikament verabreicht werden soll.

                                                                    ShortVerabreichungsweg
                                                                    Control0..1
                                                                    BindingFor example codes, see SNOMEDCTRouteCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/route-codes|4.0.1)

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

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Requirements

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

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

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

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

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

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

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode defined by a terminology system
                                                                      Comments

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

                                                                      Control0..*
                                                                      TypeCoding
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summarytrue
                                                                      Requirements

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

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.route.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • pattern @ $this
                                                                      • 332. MedicationRequest.dosageInstruction.route.coding:EDQM
                                                                        Slice NameEDQM
                                                                        Definition

                                                                        Ein Verweis auf einen durch EDQM Standard Terms definierten Code

                                                                        ShortEDQM Code
                                                                        Comments

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

                                                                        Control0..1
                                                                        BindingThe codes SHOULD be taken from Medicine EDQM Route of Administration - IPS
                                                                        (preferred to http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration)

                                                                        EDQM Standard Terms

                                                                        TypeCoding
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Requirements

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

                                                                        Pattern Value{
                                                                          "system" : "http://standardterms.edqm.eu"
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        334. MedicationRequest.dosageInstruction.route.coding:EDQM.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
                                                                        336. MedicationRequest.dosageInstruction.route.coding:EDQM.extension
                                                                        Definition

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

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

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

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

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

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

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

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

                                                                          ShortSymbol in syntax defined by the system
                                                                          Control1..1
                                                                          Typecode
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to refer to a particular code in the system.

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

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

                                                                          ShortRepresentation defined by the system
                                                                          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()))
                                                                          346. MedicationRequest.dosageInstruction.route.coding:EDQM.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()))
                                                                          348. MedicationRequest.dosageInstruction.route.coding:SNOMED
                                                                          Slice NameSNOMED
                                                                          Definition

                                                                          Ein Verweis auf einen von SNOMED CT definierten Code

                                                                          ShortSNOMED CT Code
                                                                          Comments

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

                                                                          Control0..1
                                                                          TypeCoding
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Requirements

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

                                                                          Pattern Value{
                                                                            "system" : "http://snomed.info/sct"
                                                                          }
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          350. MedicationRequest.dosageInstruction.route.coding:SNOMED.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
                                                                          352. MedicationRequest.dosageInstruction.route.coding:SNOMED.extension
                                                                          Definition

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

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

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

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

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

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

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

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

                                                                            ShortSymbol in syntax defined by the system
                                                                            Control1..1
                                                                            Typecode
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to refer to a particular code in the system.

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

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

                                                                            ShortRepresentation defined by the system
                                                                            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()))
                                                                            362. MedicationRequest.dosageInstruction.route.coding:SNOMED.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()))
                                                                            364. MedicationRequest.dosageInstruction.route.text
                                                                            Definition

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

                                                                            ShortPlain text representation of the concept
                                                                            Comments

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

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

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

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

                                                                            Technique for administering medication.

                                                                            ShortTechnique for administering medication
                                                                            Comments

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

                                                                            Control0..1
                                                                            BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

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

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summarytrue
                                                                            Requirements

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

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

                                                                            Die verabreichte Menge des Medikaments.

                                                                            ShortMenge des verabreichten Medikaments
                                                                            Control0..*
                                                                            TypeElement
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            370. MedicationRequest.dosageInstruction.doseAndRate.id
                                                                            Definition

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

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

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

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

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

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

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

                                                                              ShortThe kind of dose or rate specified
                                                                              Control0..1
                                                                              BindingFor example codes, see DoseAndRateType
                                                                              (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                                                                              The kind of dose or rate specified.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summarytrue
                                                                              Requirements

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

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

                                                                              Amount of medication per dose.

                                                                              ShortAmount of medication per dose
                                                                              Comments

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

                                                                              Control0..1
                                                                              TypeChoice of: Range, Quantity(SimpleQuantity)
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                                                              Summarytrue
                                                                              Requirements

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

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                              • type @ $this
                                                                              • 378. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange
                                                                                Slice NamedoseRange
                                                                                Definition

                                                                                Amount of medication per dose.

                                                                                ShortAmount of medication per dose
                                                                                Comments

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

                                                                                Control0..1
                                                                                TypeRange
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Requirements

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

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

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

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

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

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

                                                                                  The low limit. The boundary is inclusive.

                                                                                  ShortLow limit
                                                                                  Comments

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

                                                                                  Control0..1
                                                                                  TypeQuantity(SimpleQuantity)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  386. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.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
                                                                                  388. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension
                                                                                  Definition

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

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

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

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

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

                                                                                    ShortNumerical value (with implicit precision)
                                                                                    Comments

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

                                                                                    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()))
                                                                                    392. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.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()))
                                                                                    394. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.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()))
                                                                                    396. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system
                                                                                    Definition

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

                                                                                    ShortSystem that defines coded unit form
                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: qty-3
                                                                                    Typeuri
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

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

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

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

                                                                                    ShortCoded form of the unit
                                                                                    Comments

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

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

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

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

                                                                                    The high limit. The boundary is inclusive.

                                                                                    ShortHigh limit
                                                                                    Comments

                                                                                    If the high element is missing, the high boundary is not known.

                                                                                    Control0..1
                                                                                    TypeQuantity(SimpleQuantity)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    402. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id
                                                                                    Definition

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

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    404. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension
                                                                                    Definition

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

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

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

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

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

                                                                                      ShortNumerical value (with implicit precision)
                                                                                      Comments

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

                                                                                      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()))
                                                                                      408. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.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()))
                                                                                      410. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.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()))
                                                                                      412. MedicationRequest.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system
                                                                                      Definition

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

                                                                                      ShortSystem that defines coded unit form
                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: qty-3
                                                                                      Typeuri
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Must Supporttrue
                                                                                      Summarytrue
                                                                                      Requirements

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

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

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

                                                                                      ShortCoded form of the unit
                                                                                      Comments

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

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

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

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

                                                                                      Menge des Medikaments pro Dosis.

                                                                                      ShortMenge des Medikaments pro Dosis
                                                                                      Comments

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

                                                                                      Control0..1
                                                                                      BindingThe codes SHALL be taken from Dosage DoseQuantity ValueSet
                                                                                      (required to http://ig.fhir.de/igs/medication/ValueSet/DosageDoseQuantityDE)
                                                                                      TypeQuantity(SimpleQuantity)
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summarytrue
                                                                                      Requirements

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

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

                                                                                      Amount of medication per unit of time.

                                                                                      ShortAmount of medication per unit of time
                                                                                      Comments

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

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

                                                                                      Control0..1
                                                                                      TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                      Summarytrue
                                                                                      Requirements

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

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.doseAndRate.rate[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                      • type @ $this
                                                                                      • 420. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio
                                                                                        Slice NamerateRatio
                                                                                        Definition

                                                                                        Amount of medication per unit of time.

                                                                                        ShortAmount of medication per unit of time
                                                                                        Comments

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

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

                                                                                        Control0..1
                                                                                        TypeRatio
                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summarytrue
                                                                                        Requirements

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

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

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

                                                                                        ShortAdditional content defined by implementations
                                                                                        Comments

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

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

                                                                                          The value of the numerator.

                                                                                          ShortNumerator value
                                                                                          Control0..1
                                                                                          TypeQuantity
                                                                                          Is Modifierfalse
                                                                                          Must Supporttrue
                                                                                          Summarytrue
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          428. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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
                                                                                          430. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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.dosageInstruction.doseAndRate.rate[x].numerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 432. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.value
                                                                                            Definition

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

                                                                                            ShortNumerical value (with implicit precision)
                                                                                            Comments

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

                                                                                            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()))
                                                                                            434. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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..1
                                                                                            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()))
                                                                                            436. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.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()))
                                                                                            438. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.numerator.system
                                                                                            Definition

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

                                                                                            ShortSystem that defines coded unit form
                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: qty-3
                                                                                            Typeuri
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Requirements

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

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

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

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

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

                                                                                            The value of the denominator.

                                                                                            ShortDenominator value
                                                                                            Control0..1
                                                                                            TypeQuantity
                                                                                            Is Modifierfalse
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            444. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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
                                                                                            446. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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.dosageInstruction.doseAndRate.rate[x].denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 448. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.value
                                                                                              Definition

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

                                                                                              ShortNumerical value (with implicit precision)
                                                                                              Comments

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

                                                                                              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()))
                                                                                              450. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.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..1
                                                                                              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()))
                                                                                              452. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.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()))
                                                                                              454. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRatio.denominator.system
                                                                                              Definition

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

                                                                                              ShortSystem that defines coded unit form
                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: qty-3
                                                                                              Typeuri
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Must Supporttrue
                                                                                              Summarytrue
                                                                                              Requirements

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

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

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

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

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

                                                                                              Amount of medication per unit of time.

                                                                                              ShortAmount of medication per unit of time
                                                                                              Comments

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

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

                                                                                              Control0..1
                                                                                              TypeRange
                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                              Is Modifierfalse
                                                                                              Must Supporttrue
                                                                                              Summarytrue
                                                                                              Requirements

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

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

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

                                                                                              ShortAdditional content defined by implementations
                                                                                              Comments

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

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

                                                                                                The low limit. The boundary is inclusive.

                                                                                                ShortLow limit
                                                                                                Comments

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

                                                                                                Control0..1
                                                                                                TypeQuantity(SimpleQuantity)
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                466. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.id
                                                                                                Definition

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

                                                                                                ShortUnique id for inter-element referencing
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                Summaryfalse
                                                                                                468. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.extension
                                                                                                Definition

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

                                                                                                ShortAdditional content defined by implementations
                                                                                                Comments

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

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

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

                                                                                                  ShortNumerical value (with implicit precision)
                                                                                                  Comments

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

                                                                                                  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()))
                                                                                                  472. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.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()))
                                                                                                  474. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.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()))
                                                                                                  476. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.low.system
                                                                                                  Definition

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

                                                                                                  ShortSystem that defines coded unit form
                                                                                                  Control1..1
                                                                                                  This element is affected by the following invariants: qty-3
                                                                                                  Typeuri
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

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

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

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

                                                                                                  ShortCoded form of the unit
                                                                                                  Comments

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

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

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

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

                                                                                                  The high limit. The boundary is inclusive.

                                                                                                  ShortHigh limit
                                                                                                  Comments

                                                                                                  If the high element is missing, the high boundary is not known.

                                                                                                  Control0..1
                                                                                                  TypeQuantity(SimpleQuantity)
                                                                                                  Is Modifierfalse
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  482. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.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
                                                                                                  484. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.extension
                                                                                                  Definition

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

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

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

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

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

                                                                                                    ShortNumerical value (with implicit precision)
                                                                                                    Comments

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

                                                                                                    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()))
                                                                                                    488. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.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()))
                                                                                                    490. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.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()))
                                                                                                    492. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateRange.high.system
                                                                                                    Definition

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

                                                                                                    ShortSystem that defines coded unit form
                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: qty-3
                                                                                                    Typeuri
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

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

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

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

                                                                                                    ShortCoded form of the unit
                                                                                                    Comments

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

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

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

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

                                                                                                    Amount of medication per unit of time.

                                                                                                    ShortAmount of medication per unit of time
                                                                                                    Comments

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

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

                                                                                                    Control0..1
                                                                                                    TypeQuantity(SimpleQuantity)
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    Is Modifierfalse
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

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

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

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

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

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

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

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

                                                                                                      ShortNumerical value (with implicit precision)
                                                                                                      Comments

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

                                                                                                      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()))
                                                                                                      504. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.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()))
                                                                                                      506. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.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()))
                                                                                                      508. MedicationRequest.dosageInstruction.doseAndRate.rate[x]:rateQuantity.system
                                                                                                      Definition

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

                                                                                                      ShortSystem that defines coded unit form
                                                                                                      Control1..1
                                                                                                      This element is affected by the following invariants: qty-3
                                                                                                      Typeuri
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Must Supporttrue
                                                                                                      Summarytrue
                                                                                                      Requirements

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

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

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

                                                                                                      ShortCoded form of the unit
                                                                                                      Comments

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

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

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

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

                                                                                                      Upper limit on medication per unit of time.

                                                                                                      ShortUpper limit on medication per unit of time
                                                                                                      Comments

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

                                                                                                      Control0..1
                                                                                                      TypeRatio
                                                                                                      Is Modifierfalse
                                                                                                      Must Supporttrue
                                                                                                      Summarytrue
                                                                                                      Requirements

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

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

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

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

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

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

                                                                                                        The value of the numerator.

                                                                                                        ShortNumerator value
                                                                                                        Control0..1
                                                                                                        TypeQuantity
                                                                                                        Is Modifierfalse
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        520. MedicationRequest.dosageInstruction.maxDosePerPeriod.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
                                                                                                        522. MedicationRequest.dosageInstruction.maxDosePerPeriod.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.dosageInstruction.maxDosePerPeriod.numerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 524. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.value
                                                                                                          Definition

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

                                                                                                          ShortNumerical value (with implicit precision)
                                                                                                          Comments

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

                                                                                                          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()))
                                                                                                          526. MedicationRequest.dosageInstruction.maxDosePerPeriod.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..1
                                                                                                          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()))
                                                                                                          528. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.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()))
                                                                                                          530. MedicationRequest.dosageInstruction.maxDosePerPeriod.numerator.system
                                                                                                          Definition

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

                                                                                                          ShortSystem that defines coded unit form
                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: qty-3
                                                                                                          Typeuri
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

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

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

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

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

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

                                                                                                          The value of the denominator.

                                                                                                          ShortDenominator value
                                                                                                          Control0..1
                                                                                                          TypeQuantity
                                                                                                          Is Modifierfalse
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          536. MedicationRequest.dosageInstruction.maxDosePerPeriod.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
                                                                                                          538. MedicationRequest.dosageInstruction.maxDosePerPeriod.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.dosageInstruction.maxDosePerPeriod.denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 540. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.value
                                                                                                            Definition

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

                                                                                                            ShortNumerical value (with implicit precision)
                                                                                                            Comments

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

                                                                                                            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()))
                                                                                                            542. MedicationRequest.dosageInstruction.maxDosePerPeriod.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..1
                                                                                                            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()))
                                                                                                            544. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.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()))
                                                                                                            546. MedicationRequest.dosageInstruction.maxDosePerPeriod.denominator.system
                                                                                                            Definition

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

                                                                                                            ShortSystem that defines coded unit form
                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: qty-3
                                                                                                            Typeuri
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

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

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

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

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

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

                                                                                                            Upper limit on medication per administration.

                                                                                                            ShortUpper limit on medication per administration
                                                                                                            Comments

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

                                                                                                            Control0..1
                                                                                                            TypeQuantity(SimpleQuantity)
                                                                                                            Is Modifierfalse
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

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

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

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

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

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

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

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

                                                                                                              ShortNumerical value (with implicit precision)
                                                                                                              Comments

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

                                                                                                              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()))
                                                                                                              558. MedicationRequest.dosageInstruction.maxDosePerAdministration.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()))
                                                                                                              560. MedicationRequest.dosageInstruction.maxDosePerAdministration.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()))
                                                                                                              562. MedicationRequest.dosageInstruction.maxDosePerAdministration.system
                                                                                                              Definition

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

                                                                                                              ShortSystem that defines coded unit form
                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: qty-3
                                                                                                              Typeuri
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Requirements

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

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

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

                                                                                                              ShortCoded form of the unit
                                                                                                              Comments

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

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

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

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

                                                                                                              Upper limit on medication per lifetime of the patient.

                                                                                                              ShortUpper limit on medication per lifetime of the patient
                                                                                                              Control0..1
                                                                                                              TypeQuantity(SimpleQuantity)
                                                                                                              Is Modifierfalse
                                                                                                              Summarytrue
                                                                                                              Requirements

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

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              568. 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
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              570. 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
                                                                                                              572. 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())
                                                                                                              574. 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())
                                                                                                              576. MedicationRequest.dispenseRequest.initialFill
                                                                                                              Definition

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

                                                                                                              ShortFirst fill details
                                                                                                              Comments

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

                                                                                                              Control0..1
                                                                                                              TypeBackboneElement
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              578. MedicationRequest.dispenseRequest.initialFill.id
                                                                                                              Definition

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

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

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

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

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

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              582. MedicationRequest.dispenseRequest.initialFill.modifierExtension
                                                                                                              Definition

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

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

                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                              Comments

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

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

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

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

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

                                                                                                              ShortFirst fill quantity
                                                                                                              Control0..1
                                                                                                              TypeQuantity(SimpleQuantity)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              586. MedicationRequest.dispenseRequest.initialFill.duration
                                                                                                              Definition

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

                                                                                                              ShortFirst fill duration
                                                                                                              Control0..1
                                                                                                              TypeDuration
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              588. MedicationRequest.dispenseRequest.dispenseInterval
                                                                                                              Definition

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

                                                                                                              ShortMinimum period of time between dispenses
                                                                                                              Control0..1
                                                                                                              TypeDuration
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              590. MedicationRequest.dispenseRequest.validityPeriod
                                                                                                              Definition

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

                                                                                                              ShortTime period supply is authorized for
                                                                                                              Comments

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

                                                                                                              Control0..1
                                                                                                              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()))
                                                                                                              592. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
                                                                                                              Definition

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

                                                                                                              ShortNumber of refills authorized
                                                                                                              Comments

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

                                                                                                              Control0..1
                                                                                                              TypeunsignedInt
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              594. 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
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              596. 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
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              598. MedicationRequest.dispenseRequest.performer
                                                                                                              Definition

                                                                                                              Indicates the intended dispensing Organization specified by the prescriber.

                                                                                                              ShortIntended dispenser
                                                                                                              Control0..1
                                                                                                              TypeReference(Organization)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              600. MedicationRequest.substitution
                                                                                                              Definition

                                                                                                              Etwaige Einschränkungen bei der Substitution von Medikamenten

                                                                                                              ShortSubstitution
                                                                                                              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()))
                                                                                                              602. MedicationRequest.substitution.id
                                                                                                              Definition

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

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

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

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

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

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              606. MedicationRequest.substitution.modifierExtension
                                                                                                              Definition

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

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

                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                              Comments

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

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

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

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

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

                                                                                                              ShortWhether substitution is allowed or not
                                                                                                              Comments

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

                                                                                                              Control1..1
                                                                                                              BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                                                                                              (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                                                                                              Identifies the type of substitution allowed.

                                                                                                              TypeChoice of: boolean, CodeableConcept
                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Must Supporttrue
                                                                                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                              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.substitution.allowed[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                              • type @ $this
                                                                                                              • 610. MedicationRequest.substitution.allowed[x]:allowedBoolean
                                                                                                                Slice NameallowedBoolean
                                                                                                                Definition

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

                                                                                                                ShortWhether substitution is allowed or not
                                                                                                                Comments

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

                                                                                                                Control0..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
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                612. MedicationRequest.substitution.allowed[x]:allowedCodeableConcept
                                                                                                                Slice NameallowedCodeableConcept
                                                                                                                Definition

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

                                                                                                                ShortWhether substitution is allowed or not
                                                                                                                Comments

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

                                                                                                                Control0..1
                                                                                                                BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                                                                                                (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                                                                                                Identifies the type of substitution allowed.

                                                                                                                TypeCodeableConcept
                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                Is Modifierfalse
                                                                                                                Must Supporttrue
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                614. MedicationRequest.substitution.reason
                                                                                                                Definition

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

                                                                                                                ShortWhy should (not) substitution be made
                                                                                                                Control0..1
                                                                                                                BindingFor example codes, see SubstanceAdminSubstitutionReason
                                                                                                                (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

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

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

                                                                                                                Eine Verschreibung, die ersetzt wird

                                                                                                                ShortVorherige Verschreibung
                                                                                                                Control0..1
                                                                                                                TypeReference(MedicationRequest)
                                                                                                                Is Modifierfalse
                                                                                                                Must Supporttrue
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                618. MedicationRequest.detectedIssue
                                                                                                                Definition

                                                                                                                Ein tatsächliches oder potenzielles klinisches Problem mit oder zwischen einer oder mehreren aktiven oder vorgeschlagenen klinischen Maßnahmen für einen Patienten; z.B. Arzneimittelwechselwirkung, Doppeltherapie, Dosierungsalarm etc.

                                                                                                                ShortErkannte Probleme
                                                                                                                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..*
                                                                                                                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()))
                                                                                                                620. 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..*
                                                                                                                TypeReference(Provenance)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))