FHIR Implementatiegids voor de Nederlandse Kankerregistratie
1.2.2 - release

FHIR Implementatiegids voor de Nederlandse Kankerregistratie - Local Development build (v1.2.2) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: NcrEhrMedicationAgreement - Detailed Descriptions

Draft as of 2025-02-10

Definitions for the ncr-ehr-medication-agreement resource profile.

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

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.

ShortMedicationAgreementOrdering of medication for patient or group
Control0..*
Is Modifierfalse
Alternate NamesPrescription, Order, Medicatieafspraak
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
2. 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
This element is affected by the following invariants: ele-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()))
4. MedicationRequest.extension:medicationAgreementAdditionalInformation
Slice NamemedicationAgreementAdditionalInformation
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Comments

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

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(ext MedicationAgreement.MedicationAgreementAdditionalInformation) (Extension Type: CodeableConcept)
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MedicationRequest.extension:medicationAgreementAdditionalInformation.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.MedicationAgreementAdditionalInformation
8. MedicationRequest.extension:renderedDosageInstruction
Slice NamerenderedDosageInstruction
Definition

Pre-adopt from FHIR R5 of the .renderedDosageInstruction element found in various medication resources.

ShortOptional Extensions Element
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(ext RenderedDosageInstruction) (Extension Type: string)
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. MedicationRequest.extension:renderedDosageInstruction.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction
12. MedicationRequest.extension:periodOfUse
Slice NameperiodOfUse
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(ext TimeInterval.Period) (Extension Type: Period(zib TimeInterval))
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. MedicationRequest.extension:periodOfUse.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-TimeInterval.Period
16. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier
Slice NamepharmaceuticalTreatmentIdentifier
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(ext PharmaceuticalTreatment.Identifier) (Extension Type: Identifier)
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalTreatment.Identifier
20. MedicationRequest.extension:relationEpisodeOfCare
Slice NamerelationEpisodeOfCare
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Comments

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

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(ext Context EpisodeOfCare) (Extension Type: Reference(EpisodeOfCare, nl core EpisodeOfCare))
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. MedicationRequest.extension:relationEpisodeOfCare.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Context-EpisodeOfCare
24. MedicationRequest.extension:nextPractitioner
Slice NamenextPractitioner
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(ext MedicationAgreement.NextPractitioner) (Extension Type: Reference(Reference)(nl core HealthProfessional PractitionerRole))
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. MedicationRequest.extension:nextPractitioner.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.NextPractitioner
28. MedicationRequest.extension:registrationDateTime
Slice NameregistrationDateTime
Definition

Optional Extension Element - found in all resources.

ShortOptional Extensions Element
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(ext RegistrationDateTime) (Extension Type: dateTime)
Standard StatusNormative (from Trial Use)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
30. MedicationRequest.extension:registrationDateTime.url
Definition

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

Shortidentifies the meaning of the extension
Comments

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

Control1..1
Typeuri
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-RegistrationDateTime
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..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Standard StatusNormative (from Trial Use)
Requirements

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

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

    This StopType modifier extension works differently than the .status element of resources because it has a different meaning. The .status element usually represents the status of the resource at the moment of exchanging the resource. This means that over the lifetime of a resource, the status may change (and is very much related to use period). That – in itself – makes solely mapping StopType (which may never change in an instance) to .status not suitable.

    For example: suppose you want the patient to stop taking medication definitively three days from today. This is a stop medication agreement with a StopType of definitive. However today, tomorrow and the day after tomorrow the .status of this medication agreement is active and only after the end date of the usage period the .status should be stopped. Status and StopType are simply not the same thing.

    ShortOptional Extensions Element
    Comments

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

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(ext StopType) (Extension Type: CodeableConcept)
    Is Modifiertrue because This element is labeled as a modifier because StopType contains codes that mark the resource as no longer active.
    Standard StatusNormative (from Trial Use)
    Requirements

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

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

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-StopType
    38. MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule
    Slice NamerepeatPeriodCyclicalSchedule
    Definition

    Optional Extension Element - found in all resources.

    ShortOptional Extensions Element
    Comments

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

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(ext InstructionsForUse.RepeatPeriodCyclicalSchedule) (Extension Type: Duration)
    Is Modifiertrue because The dosage instructions are interpreted differently if RepeatPeriodCyclicalSchedule is present. Therefore this extension is labeled as a modifier extension.
    Standard StatusNormative (from Trial Use)
    Requirements

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

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

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule
    42. MedicationRequest.status
    Definition

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

    Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
    Comments

    This element is implictly mapped to the zib concept NL-CM:9.6.19936 (PeriodOfUse) and the concept mp-dataelement9x-88 (MedicationAgreementStopType). Unless the status is explicitly recorded, the following guidance applies:

    • When the value of PeriodOfUse.startDateTime is in the future, .status will usually be set to active.
    • When the value of PeriodOfUse.startDateTime is in the past and PeriodOfUse.endDateTime exists and its value is in the future, .status will usually be set to active.
    • When PeriodOfUse.endDateTime exists and its value is in the past and MedicationAgreementStopType has no value, .status will usually be set to completed.
    • When PeriodOfUse.endDateTime exists and its value is in the past and MedicationAgreementStopType is 385655000, .status will usually be set to on-hold.
    • When PeriodOfUse.endDateTime exists and its value is in the past, and the value of MedicationAgreementStopType is 410546004, .status will usually be set to stopped.
    • When the value of PeriodOfUse.startDateTime is in the future, the value of PeriodOfUse.endDateTime equals the value of PeriodOfUse.startDateTime and the value of MedicationAgreementStopType is 89925002, .status will usually be set to cancelled.
    • When PeriodOfUse.Duration and PeriodOfUse.startDateTime are known, PeriodOfUse.endDateTime can be deduced and the previous rules apply.
    • When a system is unable to infer the status, .status will be set to unknown. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the MedicationAgreement.

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    This element is affected by the following invariants: ele-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
    Summarytrue
    Pattern Valuecompleted
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. MedicationRequest.intent
    Definition

    Unless .intent is explicitly recorded and a more appropriate code is known, the value can be set to order because a MedicationAgreement should authorize an action for a patient, pharmacist, professional administrator et cetera.


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

    Shortproposal | 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
    This element is affected by the following invariants: ele-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
    Summarytrue
    Pattern Valueorder
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. 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.

    Control10..*
    This element is affected by the following invariants: ele-1
    BindingFor example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category
    (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

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

    TypeCodeableConcept
    Is Modifierfalse
    Standard StatusNormative (from Trial Use)
    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.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ $this
    • 48. MedicationRequest.category:medicationAgreementCode
      Slice NamemedicationAgreementCode
      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.

      Control10..1*
      This element is affected by the following invariants: ele-1
      BindingFor example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category
      (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

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

      TypeCodeableConcept
      Is Modifierfalse
      Standard StatusNormative (from Trial Use)
      Pattern Value{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "33633005"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. MedicationRequest.doNotPerform
      Definition

      If true indicates that the provider is asking for the medication request not to occur.

      ShortTrue if request is prohibiting action
      Comments

      If do not perform is not specified, the request is a positive request e.g. "do perform".

      Control0..1
      This element is affected by the following invariants: ele-1
      Typeboolean
      Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. MedicationRequest.reported[x]
      Definition

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

      ShortReported rather than primary record
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Standard StatusNormative (from Trial Use)
      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.reported[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 54. MedicationRequest.reported[x]:reportedBoolean
        Slice NamereportedBoolean
        Definition

        An indication whether the resource is original (false) or a copy from a different source (true).


        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.

        ShortCopyIndicatorReported rather than primary record
        Control0..1
        This element is affected by the following invariants: ele-1
        Typeboolean, 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
        Standard StatusNormative (from Trial Use)
        Summarytrue
        Alternate NamesKopieIndicator
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. MedicationRequest.medication[x]
        Definition

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

        ShortMedication to be taken
        Comments

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

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeReference(Medication), CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        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
        • 58. MedicationRequest.medication[x]:medicationReference
          Slice NamemedicationReference
          Definition

          The medicine agreed upon to be used.


          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.

          ShortAgreedMedicineMedication to be taken
          Comments

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

          Control1..1
          This element is affected by the following invariants: ele-1
          TypeReference(NcrEhrMedication, Medication), CodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesAfgesprokenGeneesmiddel
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. MedicationRequest.subject
          Definition

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

          ShortWho or group medication request is for
          Comments

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

          Control1..1
          This element is affected by the following invariants: ele-1
          TypeReference(NcrEhrPatient, Patient, Group)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          62. MedicationRequest.reasonCode
          Definition

          Reason for modification or discontinuation of the medication agreement.


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

          ShortReasonModificationOrDiscontinuationReason 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..1*
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from For example codes, see RedenWijzigen-StakenCodelijsthttp://hl7.org/fhir/ValueSet/condition-code
          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.42--20221114132525)

          A coded concept indicating why the medication was ordered.

          TypeCodeableConcept
          Is Modifierfalse
          Alternate NamesRedenWijzigenOfStaken
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. MedicationRequest.reasonReference
          Definition

          The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. It can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms. Please note: The BST401T file of the G standard contains a “special reference” to indicate that “exchange of the reason for prescription is essential”.


          Condition or observation that supports why the medication was ordered.

          ShortPrescriptionReasonCondition 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*
          This element is affected by the following invariants: ele-1
          TypeReference(NcrEhrCondition, Condition, Observation)
          Is Modifierfalse
          Must Supporttrue
          Alternate NamesRedenVanVoorschrijven
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          66. MedicationRequest.note
          Definition

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

          ShortInformation about the prescription
          Comments

          For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

          Control0..1*
          This element is affected by the following invariants: ele-1
          TypeAnnotation
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. MedicationRequest.note.text
          Definition

          Comments regarding to the medication agreement. For example: in consultation with the medical specialist.


          The text of the annotation in markdown format.

          ShortCommentThe annotation - text content (as markdown)
          Comments

          Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

          Control1..1
          This element is affected by the following invariants: ele-1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesToelichting
          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 found here

          0. MedicationRequest
          2. MedicationRequest.status
          Pattern Valuecompleted
          4. MedicationRequest.intent
          Pattern Valueorder
          6. MedicationRequest.medication[x]:medicationReference
          Slice NamemedicationReference
          Control1..?
          TypeReference(NcrEhrMedication)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          8. MedicationRequest.subject
          TypeReference(NcrEhrPatient)
          Must Supporttrue
          10. MedicationRequest.reasonReference
          Control1..?
          TypeReference(NcrEhrCondition)
          Must Supporttrue

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

          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.

          ShortMedicationAgreement
          Control0..*
          Alternate NamesPrescription, Order, Medicatieafspraak
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-6: A resource should have narrative for robust management (text.`div`.exists())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          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
          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
          This element is affected by the following invariants: ele-1
          TypeMeta
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. 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
          This element is affected by the following invariants: ele-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()))
          8. 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
          This element is affected by the following invariants: ele-1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. 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
          This element is affected by the following invariants: ele-1
          TypeNarrative
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. 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
          Alternate Namesinline resources, anonymous resources, contained resources
          14. 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..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Standard StatusNormative (from Trial Use)
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on MedicationRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. MedicationRequest.extension:medicationAgreementAdditionalInformation
            Slice NamemedicationAgreementAdditionalInformation
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Comments

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

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(ext MedicationAgreement.MedicationAgreementAdditionalInformation) (Extension Type: CodeableConcept)
            Standard StatusNormative (from Trial Use)
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. MedicationRequest.extension:medicationAgreementAdditionalInformation.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            XML FormatIn the XML format, this property is represented as an attribute.
            20. MedicationRequest.extension:medicationAgreementAdditionalInformation.extension
            Definition

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

            ShortAdditional content defined by implementations
            Comments

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

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Standard StatusNormative (from Trial Use)
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 22. MedicationRequest.extension:medicationAgreementAdditionalInformation.url
              Definition

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

              Shortidentifies the meaning of the extension
              Comments

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

              Control1..1
              Typeuri
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.MedicationAgreementAdditionalInformation
              24. MedicationRequest.extension:medicationAgreementAdditionalInformation.value[x]
              Definition

              Additional information includes details on the structure of the agreement made that are relevant for pharmacovigilance and fulfillment by the pharmacist. This can be used e.g. to indicate that there was a conscious decision to deviate from the norm or that the agreement is to be structured in a certain way.

              ShortMedicationAgreementAdditionalInformation
              Control0..1
              This element is affected by the following invariants: ele-1
              BindingThe codes SHALL be taken from Aanvullende Informatie voor MA
              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.45--20220310164013)
              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Standard StatusNormative (from Trial Use)
              Alternate NamesMedicatieafspraakAanvullendeInformatie
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. MedicationRequest.extension:renderedDosageInstruction
              Slice NamerenderedDosageInstruction
              Definition

              Pre-adopt from FHIR R5 of the .renderedDosageInstruction element found in various medication resources.

              ShortOptional Extensions Element
              Comments

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

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(ext RenderedDosageInstruction) (Extension Type: string)
              Standard StatusNormative (from Trial Use)
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              28. MedicationRequest.extension:renderedDosageInstruction.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              XML FormatIn the XML format, this property is represented as an attribute.
              30. MedicationRequest.extension:renderedDosageInstruction.extension
              Definition

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

              ShortAdditional content defined by implementations
              Comments

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

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Standard StatusNormative (from Trial Use)
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 32. MedicationRequest.extension:renderedDosageInstruction.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-RenderedDosageInstruction
                34. MedicationRequest.extension:renderedDosageInstruction.value[x]
                Definition

                Textual description of the complete instructions for use including the period of use.

                ShortDescription
                Comments

                The content of the rendered dosage instruction must not be different from the dose represented in the dosage instructions content.

                Control0..1
                This element is affected by the following invariants: ele-1
                Typestring
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Standard StatusNormative (from Trial Use)
                Alternate NamesOmschrijving
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. MedicationRequest.extension:periodOfUse
                Slice NameperiodOfUse
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Comments

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

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(ext TimeInterval.Period) (Extension Type: Period(zib TimeInterval))
                Standard StatusNormative (from Trial Use)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                38. MedicationRequest.extension:periodOfUse.id
                Definition

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

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                XML FormatIn the XML format, this property is represented as an attribute.
                40. MedicationRequest.extension:periodOfUse.extension
                Definition

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

                ShortAdditional content defined by implementations
                Comments

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

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Standard StatusNormative (from Trial Use)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 42. MedicationRequest.extension:periodOfUse.url
                  Definition

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

                  Shortidentifies the meaning of the extension
                  Comments

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

                  Control1..1
                  Typeuri
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-TimeInterval.Period
                  44. MedicationRequest.extension:periodOfUse.value[x]
                  Definition

                  Start date: This is the time at which the agreement was to take effect (or took effect or will take effect). This is the time at which the instructions for use in this agreement start. In the case of an agreement to discontinue use, this is the start date of the original medication agreement. The end date indicates from when the medication is to be discontinued.

                  Duration: The intended duration of use. E.g. 5 days or 8 weeks. It is not allowed to indicate the duration in months, because different months have a variable duration in days.

                  End date: The time at which the period of use ends (or ended or will end). In the case of an agreement to discontinue use, this is the time at which the medication is to be discontinued. To avoid confusion between 'to' and 'up to', the submission of time is always mandatory for the end date.

                  With medication for an indefinite period only a start date is indicated.

                  ShortPeriodOfUse
                  Comments

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

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

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypePeriod(nl core TimeInterval)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Standard StatusNormative (from Trial Use)
                  Alternate NamesTijdsInterval, nl-core-TimeInterval, Gebruiksperiode
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                  46. MedicationRequest.extension:periodOfUse.value[x].id
                  Definition

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

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  XML FormatIn the XML format, this property is represented as an attribute.
                  48. MedicationRequest.extension:periodOfUse.value[x].extension
                  Definition

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

                  ShortAdditional content defined by implementations
                  Comments

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

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Standard StatusNormative (from Trial Use)
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on MedicationRequest.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 50. MedicationRequest.extension:periodOfUse.value[x].extension:duration
                    Slice Nameduration
                    Definition

                    Optional Extension Element - found in all resources.

                    ShortOptional Extensions Element
                    Comments

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

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(ext TimeInterval.Duration) (Extension Type: Duration)
                    Standard StatusNormative (from Trial Use)
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    52. MedicationRequest.extension:periodOfUse.value[x].extension:condition
                    Slice Namecondition
                    Definition

                    Optional Extension Element - found in all resources.

                    ShortOptional Extensions Element
                    Comments

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

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(ext MedicationAgreement.PeriodOfUse.Condition) (Extension Type: string)
                    Standard StatusNormative (from Trial Use)
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    54. MedicationRequest.extension:periodOfUse.value[x].extension:condition.id
                    Definition

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

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    XML FormatIn the XML format, this property is represented as an attribute.
                    56. MedicationRequest.extension:periodOfUse.value[x].extension:condition.extension
                    Definition

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

                    ShortAdditional content defined by implementations
                    Comments

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

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Standard StatusNormative (from Trial Use)
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on MedicationRequest.extension.value[x].extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 58. MedicationRequest.extension:periodOfUse.value[x].extension:condition.url
                      Definition

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

                      Shortidentifies the meaning of the extension
                      Comments

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

                      Control1..1
                      Typeuri
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.PeriodOfUse.Condition
                      60. MedicationRequest.extension:periodOfUse.value[x].extension:condition.value[x]
                      Definition

                      Element to indicate that the start or end date is uncertain.

                      In certain situations the start or end date can depend on another piece of information. This is, for example, the case when a patient has to start or stop medication a few days before hospital admission. In that case this element is used to indicate (in free text): ‘start X days before hospital admission’ or ‘stop X days before hospital admission’. By doing this, it is clear that the entered start or end date is uncertain when the MedicationAgreement is being exchanged.

                      ShortCondition
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Standard StatusNormative (from Trial Use)
                      Alternate NamesCriterium
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      62. MedicationRequest.extension:periodOfUse.value[x].start
                      Definition

                      The start date and time of the interval.

                      ShortstartDateTime
                      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: ele-1, per-1
                      TypedateTime
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Alternate NamesstartDatumTijd
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      64. MedicationRequest.extension:periodOfUse.value[x].end
                      Definition

                      The end date and time of the interval.

                      ShortendDateTime
                      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: ele-1, per-1
                      TypedateTime
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Alternate NameseindDatumTijd
                      Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      66. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier
                      Slice NamepharmaceuticalTreatmentIdentifier
                      Definition

                      Optional Extension Element - found in all resources.

                      ShortOptional Extensions Element
                      Comments

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

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(ext PharmaceuticalTreatment.Identifier) (Extension Type: Identifier)
                      Standard StatusNormative (from Trial Use)
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      68. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.id
                      Definition

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

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      XML FormatIn the XML format, this property is represented as an attribute.
                      70. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.extension
                      Definition

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

                      ShortAdditional content defined by implementations
                      Comments

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

                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Standard StatusNormative (from Trial Use)
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 72. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.url
                        Definition

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

                        Shortidentifies the meaning of the extension
                        Comments

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

                        Control1..1
                        Typeuri
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-PharmaceuticalTreatment.Identifier
                        74. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x]
                        Definition

                        The identifier of the pharmaceutical treatment that this resource belongs to. This identifier is used to group the disparate resources that belong to a single pharmaceutical treatment.

                        ShortPharmaceutical Treatment Identifier
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeIdentifier
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Standard StatusNormative (from Trial Use)
                        Alternate NamesMedicamenteuze behandeling identificatie
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        76. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x].id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        XML FormatIn the XML format, this property is represented as an attribute.
                        78. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x].extension
                        Definition

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

                        ShortAdditional content defined by implementations
                        Comments

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

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Standard StatusNormative (from Trial Use)
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on MedicationRequest.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 80. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x].use
                          Definition

                          The purpose of this identifier.

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

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

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          BindingThe codes SHALL be taken from IdentifierUse
                          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                          Identifies the purpose for this identifier, if known .

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

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

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

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

                          ShortDescription of identifier
                          Comments

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

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

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

                          TypeCodeableConcept
                          Standard StatusNormative (from Trial Use)
                          Summarytrue
                          Requirements

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

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

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

                          ShortThe namespace for the identifier value
                          Comments

                          Identifier.system is always case sensitive.

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

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

                          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          86. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x].value
                          Definition

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

                          ShortThe value that is unique
                          Comments

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

                          Control1..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Example<br/><b>General</b>:123456
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          88. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x].period
                          Definition

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

                          ShortTime period when id is/was valid for use
                          Comments

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

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

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypePeriod
                          Standard StatusNormative (from Trial Use)
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                          90. MedicationRequest.extension:pharmaceuticalTreatmentIdentifier.value[x].assigner
                          Definition

                          Organization that issued/manages the identifier.

                          ShortOrganization that issued id (may be just text)
                          Comments

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

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeReference(Organization)
                          Standard StatusNormative (from Trial Use)
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                          92. MedicationRequest.extension:relationEpisodeOfCare
                          Slice NamerelationEpisodeOfCare
                          Definition

                          Optional Extension Element - found in all resources.

                          ShortOptional Extensions Element
                          Comments

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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension(ext Context EpisodeOfCare) (Extension Type: Reference(EpisodeOfCare, nl core EpisodeOfCare))
                          Standard StatusNormative (from Trial Use)
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          94. MedicationRequest.extension:relationEpisodeOfCare.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          XML FormatIn the XML format, this property is represented as an attribute.
                          96. MedicationRequest.extension:relationEpisodeOfCare.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Standard StatusNormative (from Trial Use)
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 98. MedicationRequest.extension:relationEpisodeOfCare.url
                            Definition

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

                            Shortidentifies the meaning of the extension
                            Comments

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

                            Control1..1
                            Typeuri
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Context-EpisodeOfCare
                            100. MedicationRequest.extension:relationEpisodeOfCare.value[x]
                            Definition

                            Identifies the episode(s) of care that this resource is relevant to. Establishes the EpisodeOfCare as a 'grouper' of resources that are relevant to that episode.

                            ShortRelationEpisodeOfCare
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeReference(EpisodeOfCare, nl core EpisodeOfCare)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Standard StatusNormative (from Trial Use)
                            Alternate NamesRelatieZorgepisode
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            102. MedicationRequest.extension:nextPractitioner
                            Slice NamenextPractitioner
                            Definition

                            Optional Extension Element - found in all resources.

                            ShortOptional Extensions Element
                            Comments

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

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(ext MedicationAgreement.NextPractitioner) (Extension Type: Reference(Reference)(nl core HealthProfessional PractitionerRole))
                            Standard StatusNormative (from Trial Use)
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            104. MedicationRequest.extension:nextPractitioner.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            XML FormatIn the XML format, this property is represented as an attribute.
                            106. MedicationRequest.extension:nextPractitioner.extension
                            Definition

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

                            ShortAdditional content defined by implementations
                            Comments

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

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Standard StatusNormative (from Trial Use)
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 108. MedicationRequest.extension:nextPractitioner.url
                              Definition

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

                              Shortidentifies the meaning of the extension
                              Comments

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

                              Control1..1
                              Typeuri
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.NextPractitioner
                              110. MedicationRequest.extension:nextPractitioner.value[x]
                              Definition

                              The author of the medication agreement, which was stopped during admission, that needs to be restarted after discharge.

                              ShortNextPractitioner
                              Comments

                              Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

                              In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeReference(Reference)(nl core HealthProfessional PractitionerRole)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Standard StatusNormative (from Trial Use)
                              Alternate NamesVolgendeBehandelaar
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                              112. MedicationRequest.extension:registrationDateTime
                              Slice NameregistrationDateTime
                              Definition

                              Optional Extension Element - found in all resources.

                              ShortOptional Extensions Element
                              Comments

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

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(ext RegistrationDateTime) (Extension Type: dateTime)
                              Standard StatusNormative (from Trial Use)
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              114. MedicationRequest.extension:registrationDateTime.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              XML FormatIn the XML format, this property is represented as an attribute.
                              116. MedicationRequest.extension:registrationDateTime.extension
                              Definition

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

                              ShortAdditional content defined by implementations
                              Comments

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

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Standard StatusNormative (from Trial Use)
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on MedicationRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 118. MedicationRequest.extension:registrationDateTime.url
                                Definition

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

                                Shortidentifies the meaning of the extension
                                Comments

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

                                Control1..1
                                Typeuri
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-RegistrationDateTime
                                120. MedicationRequest.extension:registrationDateTime.value[x]
                                Definition

                                Date and time the medication agreement was recorded. Registration date + time are required (order of the registrations must be clear in cases with multiple registrations on one day).

                                ShortRegistrationDateTime
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypedateTime
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Standard StatusNormative (from Trial Use)
                                Alternate NamesRegistratieDatumTijd
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                122. MedicationRequest.modifierExtension
                                Definition

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

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

                                ShortExtensions that cannot be ignored
                                Comments

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

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                Standard StatusNormative (from Trial Use)
                                Requirements

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

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

                                  This StopType modifier extension works differently than the .status element of resources because it has a different meaning. The .status element usually represents the status of the resource at the moment of exchanging the resource. This means that over the lifetime of a resource, the status may change (and is very much related to use period). That – in itself – makes solely mapping StopType (which may never change in an instance) to .status not suitable.

                                  For example: suppose you want the patient to stop taking medication definitively three days from today. This is a stop medication agreement with a StopType of definitive. However today, tomorrow and the day after tomorrow the .status of this medication agreement is active and only after the end date of the usage period the .status should be stopped. Status and StopType are simply not the same thing.

                                  ShortOptional Extensions Element
                                  Comments

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

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(ext StopType) (Extension Type: CodeableConcept)
                                  Is Modifiertrue because This element is labeled as a modifier because StopType contains codes that mark the resource as no longer active.
                                  Standard StatusNormative (from Trial Use)
                                  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())
                                  126. MedicationRequest.modifierExtension:stopType.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  128. MedicationRequest.modifierExtension:stopType.extension
                                  Definition

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

                                  Control0..*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Standard StatusNormative (from Trial Use)
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on MedicationRequest.modifierExtension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 130. MedicationRequest.modifierExtension:stopType.url
                                    Definition

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

                                    Shortidentifies the meaning of the extension
                                    Comments

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

                                    Control1..1
                                    Typeuri
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-StopType
                                    132. MedicationRequest.modifierExtension:stopType.value[x]
                                    Definition

                                    Stop type, the manner in which this medication is discontinued or canceled (temporary, definitive or canceled).

                                    ShortMedicationAgreementStopType
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    BindingThe codes SHALL be taken from StopTypeCodelijst
                                    (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.50--20221216102010)
                                    TypeCodeableConcept
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Standard StatusNormative (from Trial Use)
                                    Alternate NamesMedicatieafspraakStopType
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    134. MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule
                                    Slice NamerepeatPeriodCyclicalSchedule
                                    Definition

                                    Optional Extension Element - found in all resources.

                                    ShortOptional Extensions Element
                                    Comments

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

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(ext InstructionsForUse.RepeatPeriodCyclicalSchedule) (Extension Type: Duration)
                                    Is Modifiertrue because The dosage instructions are interpreted differently if RepeatPeriodCyclicalSchedule is present. Therefore this extension is labeled as a modifier extension.
                                    Standard StatusNormative (from Trial Use)
                                    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())
                                    136. MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    138. MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.extension
                                    Definition

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

                                    ShortAdditional content defined by implementations
                                    Comments

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

                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Standard StatusNormative (from Trial Use)
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on MedicationRequest.modifierExtension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 140. MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.url
                                      Definition

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

                                      Shortidentifies the meaning of the extension
                                      Comments

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

                                      Control1..1
                                      Typeuri
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-InstructionsForUse.RepeatPeriodCyclicalSchedule
                                      142. MedicationRequest.modifierExtension:repeatPeriodCyclicalSchedule.value[x]
                                      Definition

                                      The repeated period in a cyclical schedule (of one or more dosing instructions). A cyclical schedule is noted in days, the corresponding dosing duration is also in days.

                                      Examples of a cyclical schedule:
                                      contraceptive pill (21 days, 1 pill 1x a day, then skip for 7 days, repeat), repeat period here is 28 days

                                      ShortRepeatPeriodCyclicalSchedule
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeDuration
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Standard StatusNormative (from Trial Use)
                                      Alternate NamesHerhaalperiodeCyclischSchema
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      144. MedicationRequest.identifier
                                      Definition

                                      Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                                      ShortIdentification
                                      Comments

                                      This is a business identifier, not a resource identifier.

                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeIdentifier
                                      Alternate NamesIdentificatie
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      146. MedicationRequest.status
                                      Definition

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

                                      Shortactive | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown
                                      Comments

                                      This element is implictly mapped to the zib concept NL-CM:9.6.19936 (PeriodOfUse) and the concept mp-dataelement9x-88 (MedicationAgreementStopType). Unless the status is explicitly recorded, the following guidance applies:

                                      • When the value of PeriodOfUse.startDateTime is in the future, .status will usually be set to active.
                                      • When the value of PeriodOfUse.startDateTime is in the past and PeriodOfUse.endDateTime exists and its value is in the future, .status will usually be set to active.
                                      • When PeriodOfUse.endDateTime exists and its value is in the past and MedicationAgreementStopType has no value, .status will usually be set to completed.
                                      • When PeriodOfUse.endDateTime exists and its value is in the past and MedicationAgreementStopType is 385655000, .status will usually be set to on-hold.
                                      • When PeriodOfUse.endDateTime exists and its value is in the past, and the value of MedicationAgreementStopType is 410546004, .status will usually be set to stopped.
                                      • When the value of PeriodOfUse.startDateTime is in the future, the value of PeriodOfUse.endDateTime equals the value of PeriodOfUse.startDateTime and the value of MedicationAgreementStopType is 89925002, .status will usually be set to cancelled.
                                      • When PeriodOfUse.Duration and PeriodOfUse.startDateTime are known, PeriodOfUse.endDateTime can be deduced and the previous rules apply.
                                      • When a system is unable to infer the status, .status will be set to unknown. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the MedicationAgreement.
                                      Control1..1
                                      This element is affected by the following invariants: ele-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
                                      Summarytrue
                                      Pattern Valuecompleted
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      148. MedicationRequest.statusReason
                                      Definition

                                      Captures the reason for the current state of the MedicationRequest.

                                      ShortReason for current status
                                      Comments

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

                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see medicationRequest Status Reason Codes
                                      (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

                                      Identifies the reasons for a given status.

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

                                      Unless .intent is explicitly recorded and a more appropriate code is known, the value can be set to order because a MedicationAgreement should authorize an action for a patient, pharmacist, professional administrator et cetera.

                                      Shortproposal | 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
                                      This element is affected by the following invariants: ele-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
                                      Summarytrue
                                      Pattern Valueorder
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      152. 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.

                                      Control1..*
                                      This element is affected by the following invariants: ele-1
                                      BindingFor example codes, see medicationRequest Category Codes
                                      (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

                                      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
                                      Standard StatusNormative (from Trial Use)
                                      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.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ $this
                                      • 154. MedicationRequest.category:medicationAgreementCode
                                        Slice NamemedicationAgreementCode
                                        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.

                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        BindingFor example codes, see medicationRequest Category Codes
                                        (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

                                        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
                                        Standard StatusNormative (from Trial Use)
                                        Pattern Value{
                                          "coding" : [{
                                            "system" : "http://snomed.info/sct",
                                            "code" : "33633005"
                                          }]
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        156. MedicationRequest.priority
                                        Definition

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

                                        Shortroutine | urgent | asap | stat
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-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
                                        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()))
                                        158. MedicationRequest.doNotPerform
                                        Definition

                                        If true indicates that the provider is asking for the medication request not to occur.

                                        ShortTrue if request is prohibiting action
                                        Comments

                                        If do not perform is not specified, the request is a positive request e.g. "do perform".

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeboolean
                                        Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        160. MedicationRequest.reported[x]
                                        Definition

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

                                        ShortReported rather than primary record
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Standard StatusNormative (from Trial Use)
                                        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.reported[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • 162. MedicationRequest.reported[x]:reportedBoolean
                                          Slice NamereportedBoolean
                                          Definition

                                          An indication whether the resource is original (false) or a copy from a different source (true).

                                          ShortCopyIndicator
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeboolean
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Standard StatusNormative (from Trial Use)
                                          Summarytrue
                                          Alternate NamesKopieIndicator
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          164. MedicationRequest.medication[x]
                                          Definition

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

                                          ShortMedication to be taken
                                          Comments

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

                                          Control1..1
                                          This element is affected by the following invariants: ele-1
                                          TypeReference
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          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
                                          • 166. MedicationRequest.medication[x]:medicationReference
                                            Slice NamemedicationReference
                                            Definition

                                            The medicine agreed upon to be used.

                                            ShortAgreedMedicine
                                            Comments

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

                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(NcrEhrMedication)
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Must Supporttrue
                                            Summarytrue
                                            Alternate NamesAfgesprokenGeneesmiddel
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            168. MedicationRequest.subject
                                            Definition

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

                                            ShortWho or group medication request is for
                                            Comments

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

                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(NcrEhrPatient)
                                            Must Supporttrue
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            170. MedicationRequest.encounter
                                            Definition

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

                                            ShortRelationEncounter
                                            Comments

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

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(Encounter, nl core Encounter)
                                            Alternate NamesRelatieContact
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            172. MedicationRequest.supportingInformation
                                            Definition

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

                                            ShortInformation to support ordering of the medication
                                            Comments

                                            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(Resource)
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            174. MedicationRequest.authoredOn
                                            Definition

                                            The time at which the agreement was made. Appointment date + time are required (order of the appointments must be clear in cases with multiple appointments on one day)

                                            ShortMedicationAgreementDateTime
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypedateTime
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Alternate NamesMedicatieafspraakDatumTijd
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            176. MedicationRequest.requester
                                            Definition

                                            The health professional that entered the medication agreement with the patient.

                                            ShortPrescriber
                                            Comments

                                            Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

                                            In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(Reference)(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device, nl core HealthProfessional PractitionerRole)
                                            Summarytrue
                                            Alternate NamesVoorschrijver
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            178. MedicationRequest.performer
                                            Definition

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

                                            ShortIntended performer of administration
                                            Comments

                                            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            180. MedicationRequest.performerType
                                            Definition

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

                                            ShortDesired kind of performer of the medication administration
                                            Comments

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

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see ProcedurePerformerRoleCodes
                                            (example to http://hl7.org/fhir/ValueSet/performer-role)

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

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

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

                                            ShortPerson who entered the request
                                            Comments

                                            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(Practitioner, PractitionerRole)
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            184. MedicationRequest.reasonCode
                                            Definition

                                            Reason for modification or discontinuation of the medication agreement.

                                            ShortReasonModificationOrDiscontinuation
                                            Comments

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

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            BindingThe codes SHALL be taken from RedenWijzigen-StakenCodelijst
                                            (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.20.77.11.42--20221114132525)

                                            A coded concept indicating why the medication was ordered.

                                            TypeCodeableConcept
                                            Alternate NamesRedenWijzigenOfStaken
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            186. MedicationRequest.reasonReference
                                            Definition

                                            The medical reason for the prescription or for use of the medication. This can be used to enter a medical indication which was the direct cause for prescription or for use of the medication in question. It can concern every type of problem (or condition) of the patient, almost all diagnoses, complaints or symptoms. Please note: The BST401T file of the G standard contains a “special reference” to indicate that “exchange of the reason for prescription is essential”.

                                            ShortPrescriptionReason
                                            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
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(NcrEhrCondition)
                                            Must Supporttrue
                                            Alternate NamesRedenVanVoorschrijven
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            188. MedicationRequest.instantiatesCanonical
                                            Definition

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

                                            ShortInstantiates FHIR protocol or definition
                                            Comments

                                            see Canonical References

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            Typecanonical
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            190. MedicationRequest.instantiatesUri
                                            Definition

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

                                            ShortInstantiates external protocol or definition
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            Typeuri
                                            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()))
                                            192. MedicationRequest.basedOn
                                            Definition

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

                                            ShortWhat request fulfills
                                            Comments

                                            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                            194. MedicationRequest.basedOn.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            196. MedicationRequest.basedOn.extension
                                            Definition

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

                                            ShortAdditional content defined by implementations
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standard StatusNormative (from Trial Use)
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on MedicationRequest.basedOn.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 198. MedicationRequest.basedOn.extension:relationAdministrationAgreement
                                              Slice NamerelationAdministrationAgreement
                                              Definition

                                              Optional Extension Element - found in all resources.

                                              ShortOptional Extensions Element
                                              Comments

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

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension(ext RelationAdministrationAgreement) (Extension Type: Reference(mp AdministrationAgreement))
                                              Standard StatusNormative (from Trial Use)
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              200. MedicationRequest.basedOn.extension:relationAdministrationAgreement.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              202. MedicationRequest.basedOn.extension:relationAdministrationAgreement.extension
                                              Definition

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

                                              ShortAdditional content defined by implementations
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension
                                              Standard StatusNormative (from Trial Use)
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on MedicationRequest.basedOn.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 204. MedicationRequest.basedOn.extension:relationAdministrationAgreement.url
                                                Definition

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

                                                Shortidentifies the meaning of the extension
                                                Comments

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

                                                Control1..1
                                                Typeuri
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-RelationAdministrationAgreement
                                                206. MedicationRequest.basedOn.extension:relationAdministrationAgreement.value[x]
                                                Definition

                                                A reference to an AdministrationAgreement on which the MedicationAgreement or AdministrationAgreement is based.

                                                ShortRelationAdministrationAgreement
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeReference(mp AdministrationAgreement)
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Standard StatusNormative (from Trial Use)
                                                Alternate NamesRelatieToedieningsafspraak
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                208. MedicationRequest.basedOn.extension:relationMedicationUse
                                                Slice NamerelationMedicationUse
                                                Definition

                                                Optional Extension Element - found in all resources.

                                                ShortOptional Extensions Element
                                                Comments

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

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(ext MedicationAgreement.RelationMedicationUse) (Extension Type: Reference(mp MedicationUse2))
                                                Standard StatusNormative (from Trial Use)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                210. MedicationRequest.basedOn.extension:relationMedicationUse.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                212. MedicationRequest.basedOn.extension:relationMedicationUse.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Standard StatusNormative (from Trial Use)
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on MedicationRequest.basedOn.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 214. MedicationRequest.basedOn.extension:relationMedicationUse.url
                                                  Definition

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

                                                  Shortidentifies the meaning of the extension
                                                  Comments

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

                                                  Control1..1
                                                  Typeuri
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-MedicationAgreement.RelationMedicationUse
                                                  216. MedicationRequest.basedOn.extension:relationMedicationUse.value[x]
                                                  Definition

                                                  A reference to a MedicationUse2 on which the MedicationAgreement is based.

                                                  ShortRelationMedicationUse
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeReference(mp MedicationUse2)
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Standard StatusNormative (from Trial Use)
                                                  Alternate NamesRelatieMedicatiegebruik
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  218. MedicationRequest.basedOn.reference
                                                  Definition

                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                  Comments

                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1, ref-1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  220. MedicationRequest.basedOn.type
                                                  Definition

                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                  ShortType the reference refers to (e.g. "Patient")
                                                  Comments

                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

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

                                                  Aa resource (or, for logical models, the URI of the logical model).

                                                  Typeuri
                                                  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()))
                                                  222. MedicationRequest.basedOn.identifier
                                                  Definition

                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                  ShortLogical reference, when literal reference is not known
                                                  Comments

                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeIdentifier
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  224. MedicationRequest.basedOn.display
                                                  Definition

                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                  ShortText alternative for the resource
                                                  Comments

                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  226. MedicationRequest.groupIdentifier
                                                  Definition

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

                                                  ShortComposite request this is part of
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeIdentifier
                                                  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()))
                                                  228. MedicationRequest.courseOfTherapyType
                                                  Definition

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

                                                  ShortOverall pattern of medication administration
                                                  Comments

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

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  BindingFor example codes, see medicationRequest Course of Therapy Codes
                                                  (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

                                                  Identifies the overall pattern of medication administratio.

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

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

                                                  ShortAssociated insurance coverage
                                                  Comments

                                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeReference(Coverage, ClaimResponse)
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                  232. MedicationRequest.note
                                                  Definition

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

                                                  ShortInformation about the prescription
                                                  Comments

                                                  For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeAnnotation
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  234. MedicationRequest.note.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  236. MedicationRequest.note.extension
                                                  Definition

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Standard StatusNormative (from Trial Use)
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on MedicationRequest.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 238. MedicationRequest.note.author[x]
                                                    Definition

                                                    The individual responsible for making the annotation.

                                                    ShortIndividual responsible for the annotation
                                                    Comments

                                                    Organization is used when there's no need for specific attribution as to who made the comment.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    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()))
                                                    240. MedicationRequest.note.time
                                                    Definition

                                                    Indicates when this particular annotation was made.

                                                    ShortWhen the annotation was made
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypedateTime
                                                    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()))
                                                    242. MedicationRequest.note.text
                                                    Definition

                                                    Comments regarding to the medication agreement. For example: in consultation with the medical specialist.

                                                    ShortComment
                                                    Comments

                                                    Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typemarkdown
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Alternate NamesToelichting
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    244. MedicationRequest.dosageInstruction
                                                    Definition

                                                    Instructions for the use of the medication, e.g. dose and route of administration.

                                                    ShortDosingInstructions / InstructionsForUse
                                                    Comments

                                                    This element mostly represents the DosingInstructions container from zib InstructionsForUse, but also includes the AdditionalInstructions and RouteOfAdministration concepts, which are normally placed on the same level as this container. As a result, these concepts are duplicated in every repetition of this element, even though these concepts should be present just once according to the zib.

                                                    This element does not contain a mapping to the Dosage container from zib InstructionsForUse. However, all child concepts of the Dosage concept are mapped. If an instance of zib container DosingInstructions contains multiple Dosage containers, each of these results in a separate instance of the FHIR Dosage data type conforming to this profile, wherein .sequence (zib concept SequenceNumber) and .timing.repeat.bounds[x]:boundsDuration (zib concept DoseDuration) are equal.

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeDosage(mp InstructionsForUse.DosageInstructions)
                                                    Alternate NamesDoseerinstructie, Gebruiksinstructie
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    246. MedicationRequest.dispenseRequest
                                                    Definition

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

                                                    ShortMedication supply authorization
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeBackboneElement
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    248. 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
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    250. 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..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    Standard StatusNormative (from Trial Use)
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 252. MedicationRequest.dispenseRequest.modifierExtension
                                                      Definition

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

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

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

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

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

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

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

                                                      Indicates the quantity or duration for the first dispense of the medication.

                                                      ShortFirst fill details
                                                      Comments

                                                      If populating this element, either the quantity or the duration must be included.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeBackboneElement
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      256. 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
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      258. 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..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Standard StatusNormative (from Trial Use)
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on MedicationRequest.dispenseRequest.initialFill.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 260. 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..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

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

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

                                                        The amount or quantity to provide as part of the first dispense.

                                                        ShortFirst fill quantity
                                                        Comments

                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeQuantity(SimpleQuantity)
                                                        Is Modifierfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                        sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                        264. MedicationRequest.dispenseRequest.initialFill.duration
                                                        Definition

                                                        The length of time that the first dispense is expected to last.

                                                        ShortFirst fill duration
                                                        Comments

                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeDuration
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                        drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (code.exists() implies ((system = %ucum) and value.exists()))
                                                        266. MedicationRequest.dispenseRequest.dispenseInterval
                                                        Definition

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

                                                        ShortMinimum period of time between dispenses
                                                        Comments

                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeDuration
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                        drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (code.exists() implies ((system = %ucum) and value.exists()))
                                                        268. MedicationRequest.dispenseRequest.validityPeriod
                                                        Definition

                                                        This indicates the validity period of a prescription (stale dating the Prescription).

                                                        ShortTime period supply is authorized for
                                                        Comments

                                                        It reflects the prescribers' perspective for the validity of the prescription. Dispenses must not be made against the prescription outside of this period. The lower-bound of the Dispensing Window signifies the earliest date that the prescription can be filled for the first time. If an upper-bound is not specified then the Prescription is open-ended or will default to a stale-date based on regulations.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypePeriod
                                                        Requirements

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

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                        270. 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
                                                        This element is affected by the following invariants: ele-1
                                                        TypeunsignedInt
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        272. MedicationRequest.dispenseRequest.quantity
                                                        Definition

                                                        The amount that is to be dispensed for one fill.

                                                        ShortAmount of medication to supply per dispense
                                                        Comments

                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeQuantity(SimpleQuantity)
                                                        Is Modifierfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                        sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                        274. 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
                                                        This element is affected by the following invariants: ele-1
                                                        TypeDuration
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                        drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (code.exists() implies ((system = %ucum) and value.exists()))
                                                        276. MedicationRequest.dispenseRequest.performer
                                                        Definition

                                                        Indicates the intended dispensing Organization specified by the prescriber.

                                                        ShortIntended dispenser
                                                        Comments

                                                        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeReference(Organization)
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                        278. MedicationRequest.substitution
                                                        Definition

                                                        Indicates whether or not substitution can or should be part of the dispense. In some cases, substitution must happen, in other cases substitution must not happen. This block explains the prescriber's intent. If nothing is specified substitution may be done.

                                                        ShortAny restrictions on medication substitution
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeBackboneElement
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        280. 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
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        282. 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..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Standard StatusNormative (from Trial Use)
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on MedicationRequest.substitution.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 284. MedicationRequest.substitution.modifierExtension
                                                          Definition

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

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

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

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

                                                          ShortWhether substitution is allowed or not
                                                          Comments

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

                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          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]
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          288. MedicationRequest.substitution.reason
                                                          Definition

                                                          Indicates the reason for the substitution, or why substitution must or must not be performed.

                                                          ShortWhy should (not) substitution be made
                                                          Comments

                                                          Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          BindingFor example codes, see SubstanceAdminSubstitutionReason
                                                          (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                                                          A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

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

                                                          A link to a medication agreement that is altered or canceled.

                                                          ShortRelationMedicationAgreement
                                                          Comments

                                                          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeReference(MedicationRequest, mp MedicationAgreement)
                                                          Alternate NamesRelatieMedicatieafspraak
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                          292. MedicationRequest.detectedIssue
                                                          Definition

                                                          Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc.

                                                          ShortClinical Issue with action
                                                          Comments

                                                          This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeReference(DetectedIssue)
                                                          Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                          294. MedicationRequest.eventHistory
                                                          Definition

                                                          Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource.

                                                          ShortA list of events of interest in the lifecycle
                                                          Comments

                                                          This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeReference(Provenance)
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))