Guia de Implementação do Registro de Atendimento Clínico (RAC) da RNDS
0.1.0 - CI Build Brazil flag

Guia de Implementação do Registro de Atendimento Clínico (RAC) da RNDS - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: BRPrescricaoMedicamento - Detailed Descriptions

Page standards status: Informative Maturity Level: 1

Definitions for the BRPrescricaoMedicamento resource profile.

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

0. MedicationRequest
2. MedicationRequest.implicitRules
Control0..0
4. MedicationRequest.language
Control0..0
6. MedicationRequest.contained
Control0..0
8. MedicationRequest.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0
10. MedicationRequest.statusReason
Control0..0
12. MedicationRequest.category
Control0..0
14. MedicationRequest.priority
Control0..0
16. MedicationRequest.doNotPerform
Control0..0
18. MedicationRequest.reported[x]
Control0..0
20. MedicationRequest.medication[x]
Definition

Identificação e informações sobre o medicamento prescrito.

ShortMedicamento
BindingThe codes SHALL be taken from Indicativo de prescrição não estruturada ou medicamento não identificado
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BRPrescricaoNaoEstruturada)

Justificativa da ausência de dados estruturados sobre o medicamento.

TypeChoice of: CodeableConcept, Reference(Medicamento)
[x] NoteSee Choice of Data Types for further information about how to use [x]
22. MedicationRequest.subject
Definition

Quem ou o quê a composição se refere. Pode ser um indivíduo, dispositivo, grupos (de indivíduos, dispositivos etc.).

ShortSujeito da Composição
TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
24. MedicationRequest.subject.reference
Control0..0
26. MedicationRequest.subject.type
Control0..0
28. MedicationRequest.subject.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
30. MedicationRequest.subject.identifier.use
Control0..0
32. MedicationRequest.subject.identifier.type
Control0..0
34. MedicationRequest.subject.identifier.period
Control0..0
36. MedicationRequest.subject.identifier.assigner
Control0..0
38. MedicationRequest.subject.display
Control0..0
40. MedicationRequest.encounter
Control0..0
42. MedicationRequest.supportingInformation
Control0..0
44. MedicationRequest.authoredOn
Definition

Data e hora da prescrição realizada.

ShortData e hora da prescrição
Control1..?
46. MedicationRequest.requester
Definition

Identifica pelo número de inscrição no Cadastro Nacional de Estabelecimentos de Saúde o Estabelecimento de Saúde que realizou a prescrição de medicamento.

ShortEstabelecimento de Saúde prescritor
TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0)
48. MedicationRequest.requester.reference
Control0..0
50. MedicationRequest.requester.type
Control0..0
52. MedicationRequest.requester.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
54. MedicationRequest.requester.identifier.use
Control0..0
56. MedicationRequest.requester.identifier.type
Control0..0
58. MedicationRequest.requester.identifier.period
Control0..0
60. MedicationRequest.requester.identifier.assigner
Control0..0
62. MedicationRequest.requester.display
Control0..0
64. MedicationRequest.performer
Control0..0
66. MedicationRequest.performerType
Control0..0
68. MedicationRequest.recorder
Definition

Identificação e informações do profissional que realizou a prescrição de medicamento.

ShortProfissional prescritor
Control1..?
TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRProfissional-1.0)
70. MedicationRequest.recorder.reference
Control0..0
72. MedicationRequest.recorder.type
Control0..0
74. MedicationRequest.recorder.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
76. MedicationRequest.recorder.identifier.use
Control0..0
78. MedicationRequest.recorder.identifier.type
Control0..0
80. MedicationRequest.recorder.identifier.period
Control0..0
82. MedicationRequest.recorder.identifier.assigner
Control0..0
84. MedicationRequest.recorder.display
Control0..0
86. MedicationRequest.reasonCode
Control0..0
88. MedicationRequest.reasonReference
Control0..0
90. MedicationRequest.instantiatesCanonical
Control0..0
92. MedicationRequest.instantiatesUri
Control0..0
94. MedicationRequest.basedOn
Control0..0
96. MedicationRequest.groupIdentifier
Control0..0
98. MedicationRequest.courseOfTherapyType
Control0..0
100. MedicationRequest.insurance
Control0..0
102. MedicationRequest.note
Definition

Definição da descrição do uso do medicamento e prescrição não estruturada.

ShortNotas não estruturadas
Control0..1
104. MedicationRequest.dosageInstruction
Control0..1
106. MedicationRequest.dosageInstruction.sequence
Control0..0
108. MedicationRequest.dosageInstruction.text
Definition

Descrição da prescrição e/ou posologia de medicamento de forma livre, em texto. O profissional prescritor deverá descrever todas as informações necessárias a uma prescrição e/ou posologia, entre outros elementos relevantes.

ShortPrescrição e/ou Posologia Não Estruturada
110. MedicationRequest.dosageInstruction.additionalInstruction
Control0..0
112. MedicationRequest.dosageInstruction.patientInstruction
Definition

Orientações sobre o uso do medicamento prescrito.

ShortOrientações sobre o uso do medicamento
114. MedicationRequest.dosageInstruction.timing
Definition

Frequência de uso do medicamento

ShortFrequência de uso do medicamento
116. MedicationRequest.dosageInstruction.timing.event
Control0..0
118. MedicationRequest.dosageInstruction.timing.repeat
Control1..?
120. MedicationRequest.dosageInstruction.timing.repeat.extension
Control0..?
SlicingThis element introduces a set of slices on MedicationRequest.dosageInstruction.timing.repeat.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 122. MedicationRequest.dosageInstruction.timing.repeat.extension:period
    Slice Nameperiod
    Definition

    Descritor quantitativo da unidade de tempo entre doses.

    ShortExtensão - Intervalo entre doses
    Control0..1
    TypeExtension(Intervalo de Doses) (Complex Extension)
    124. MedicationRequest.dosageInstruction.timing.repeat.extension:period.url
    Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRIntervaloDoses
    126. MedicationRequest.dosageInstruction.timing.repeat.extension:when
    Slice Namewhen
    Definition

    Em qual momento do dia ocorre o consumo do medicamento: Manhã, tarde, noite.

    ShortExtensão - Turno do dia
    Control0..1
    TypeExtension(Turno) (Extension Type: code)
    128. MedicationRequest.dosageInstruction.timing.repeat.extension:when.url
    Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRTurno
    130. MedicationRequest.dosageInstruction.timing.repeat.extension:when.value[x]
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    132. MedicationRequest.dosageInstruction.timing.repeat.extension:when.value[x].id
    Control0..0
    134. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
    Control0..0
    136. MedicationRequest.dosageInstruction.timing.repeat.count
    Definition

    Número de doses a cada uso do medicamento (ex.: 1x, 2x, 3x 4x etc.)

    ShortRepetições de dose
    Control1..?
    138. MedicationRequest.dosageInstruction.timing.repeat.countMax
    Definition

    Representa a quantidade total de doses prescritas para o medicamento: se for mais de uma, deve ser considerado como 'Dose Contínua'; do contrário, deve ser considerado como 'Dose Única'.

    ShortQuantidade total de doses
    Control1..?
    Min Value1
    Max Value2147483647
    140. MedicationRequest.dosageInstruction.timing.repeat.duration
    Control0..0
    142. MedicationRequest.dosageInstruction.timing.repeat.durationMax
    Control0..0
    144. MedicationRequest.dosageInstruction.timing.repeat.durationUnit
    Control0..0
    146. MedicationRequest.dosageInstruction.timing.repeat.frequency
    Definition

    Intervalo, em horas, de cada uso do medicamento.

    ShortIntervalo de dose
    148. MedicationRequest.dosageInstruction.timing.repeat.frequencyMax
    Control0..0
    150. MedicationRequest.dosageInstruction.timing.repeat.period
    Definition

    Descritor quantitativo da unidade de tempo entre doses.

    ShortIntervalo entre doses
    Control0..0
    152. MedicationRequest.dosageInstruction.timing.repeat.periodMax
    Control0..0
    154. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
    Definition

    Unidade de tempo entre doses (ex.: hora, dia, semana, mês etc.), em unidades UCUM.

    ShortUnidade de tempo entre doses
    Control0..0
    156. MedicationRequest.dosageInstruction.timing.repeat.dayOfWeek
    Control0..0
    158. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
    Control0..0
    160. MedicationRequest.dosageInstruction.timing.repeat.when
    Definition

    Em qual momento do dia ocorre o consumo do medicamento: Manhã, tarde, noite.

    ShortTurno do dia
    Control0..0
    162. MedicationRequest.dosageInstruction.timing.repeat.offset
    Control0..0
    164. MedicationRequest.dosageInstruction.timing.code
    Control0..0
    166. MedicationRequest.dosageInstruction.asNeeded[x]
    Definition

    Representa a necessidade do uso contínuo do medicamento.

    ShortUso se necessário
    Typeboolean
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    168. MedicationRequest.dosageInstruction.site
    Control0..0
    170. MedicationRequest.dosageInstruction.route
    Definition

    Via de Adiministração do medicamento prescrito.

    ShortVia de Administração
    Control1..?
    BindingThe codes SHALL be taken from Via de Administração do Imunobiológico
    (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRViaAdministracao-1.0)

    Via de Administração

    172. MedicationRequest.dosageInstruction.method
    Control0..0
    174. MedicationRequest.dosageInstruction.doseAndRate
    Control0..1
    176. MedicationRequest.dosageInstruction.doseAndRate.type
    Definition

    Unidade de consumo do medicamento prescrito (ex.: comprimido, cápsula, aplicação, mL, gota, copo dosador, infusão etc.).

    ShortUnidade de consumo da dose
    Control1..?
    BindingThe codes SHALL be taken from Unidade de Consumo
    (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeConsumo)

    Unidade de consumo da dose

    178. MedicationRequest.dosageInstruction.doseAndRate.type.coding
    BindingThe codes SHALL be taken from Unidade de Consumo
    (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeConsumo)

    Determina a unidade de consumo

    180. MedicationRequest.dosageInstruction.doseAndRate.type.coding.version
    NoteThis is a business versionId, not a resource version id (see discussion)
    Control0..0
    182. MedicationRequest.dosageInstruction.doseAndRate.type.coding.display
    Control0..0
    184. MedicationRequest.dosageInstruction.doseAndRate.type.coding.userSelected
    Control0..0
    186. MedicationRequest.dosageInstruction.doseAndRate.type.text
    Control0..0
    188. MedicationRequest.dosageInstruction.doseAndRate.dose[x]
    Definition

    Quantidade da unidade de consumo do medicamento prescrito a cada dose.

    ShortQuantidade da Dose
    Control1..?
    TypeQuantity
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    190. MedicationRequest.dosageInstruction.doseAndRate.dose[x].unit
    Control0..0
    192. MedicationRequest.dosageInstruction.doseAndRate.dose[x].system
    Control0..0
    194. MedicationRequest.dosageInstruction.doseAndRate.dose[x].code
    Control0..0
    196. MedicationRequest.dosageInstruction.doseAndRate.rate[x]
    Control0..0
    TypeQuantity
    198. MedicationRequest.dosageInstruction.maxDosePerPeriod
    Control0..0
    200. MedicationRequest.dosageInstruction.maxDosePerAdministration
    Definition

    Quantidade máxima da dose a ser dispensada por atendimento.

    ShortQuantidade a ser dispensada por atendimento
    Control1..?
    202. MedicationRequest.dosageInstruction.maxDosePerAdministration.unit
    Control0..0
    204. MedicationRequest.dosageInstruction.maxDosePerAdministration.system
    Control0..0
    206. MedicationRequest.dosageInstruction.maxDosePerAdministration.code
    Control0..0
    208. MedicationRequest.dosageInstruction.maxDosePerLifetime
    Control0..0
    210. MedicationRequest.dispenseRequest
    212. MedicationRequest.dispenseRequest.initialFill
    Control0..0
    214. MedicationRequest.dispenseRequest.dispenseInterval
    Definition

    Intervalo, em horas, de cada uso do medicamento.

    ShortIntervalo em horas de cada dose do medicamento
    Control0..0
    216. MedicationRequest.dispenseRequest.validityPeriod
    Definition

    Representa a duração do uso do medicamento prescrito.

    ShortDuração de uso do medicamento
    Control1..?
    218. MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
    Control0..0
    220. MedicationRequest.dispenseRequest.quantity
    ShortTotal do tratamento
    222. MedicationRequest.dispenseRequest.quantity.value
    Control1..?
    224. MedicationRequest.dispenseRequest.quantity.unit
    Control0..0
    226. MedicationRequest.dispenseRequest.quantity.system
    Control0..0
    228. MedicationRequest.dispenseRequest.quantity.code
    Control0..0
    230. MedicationRequest.dispenseRequest.expectedSupplyDuration
    Control0..0
    232. MedicationRequest.dispenseRequest.performer
    Control0..0
    234. MedicationRequest.substitution
    Control0..0
    236. MedicationRequest.priorPrescription
    Control0..0
    238. MedicationRequest.detectedIssue
    Control0..0
    240. MedicationRequest.eventHistory
    Control0..0

    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.

    ShortOrdering of medication for patient or group
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Alternate NamesPrescription, Order
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. MedicationRequest.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..01
    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.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..01
    BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
    (preferred to http://hl7.org/fhir/ValueSet/languages)

    A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. 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..0*
    TypeResource
    Is Modifierfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    8. MedicationRequest.modifierExtension
    Definition

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

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

    ShortExtensions that cannot be ignored
    Comments

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

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

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

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

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

    ShortExternal ids for this request
    Comments

    This is a business identifier, not a resource identifier.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..0*
    TypeIdentifier
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. 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 labeled as a modifier because the status contains codes that mark the resource as not currently valid.

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

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

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. MedicationRequest.statusReason
    Definition

    Captures the reason for the current state of the MedicationRequest.

    ShortReason for current status
    Comments

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

    Control0..01
    BindingFor example codes, see medicationRequest Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-status-reason
    (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

    Identifies the reasons for a given status.

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

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

    Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

    ShortType of medication usage
    Comments

    The category can be used to include where the medication is expected to be consumed or other types of requests.

    Control0..0*
    BindingFor example codes, see medicationRequest Category Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-category
    (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

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

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

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

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

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

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

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

    ShortTrue if request is prohibiting action
    Comments

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

    Control0..01
    Typeboolean
    Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. MedicationRequest.reported[x]
    Definition

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

    ShortReported rather than primary record
    Control0..01
    TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. MedicationRequest.medication[x]
    Definition

    Identificação e informações sobre o medicamento prescrito.


    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.

    ShortMedicamentoMedication 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
    BindingThe codes SHALL be taken from For example codes, see Indicativo de prescrição não estruturada ou medicamento não identificadohttp://hl7.org/fhir/ValueSet/medication-codes
    (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRPrescricaoNaoEstruturada)

    Justificativa da ausência de dados estruturados sobre o medicamento.


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

    TypeChoice of: CodeableConcept, Reference(Medicamento, Medication)
    [x] NoteSee Choice of Data Types for 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()))
    28. MedicationRequest.subject
    Definition

    Quem ou o quê a composição se refere. Pode ser um indivíduo, dispositivo, grupos (de indivíduos, dispositivos etc.).


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

    ShortSujeito da ComposiçãoWho or group medication request is for
    Comments

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

    Control1..1
    TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0, Patient, Group)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. MedicationRequest.subject.reference
    Definition

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

    ShortLiteral reference, Relative, internal or absolute URL
    Comments

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

    Control0..01
    This element is affected by the following invariants: ref-1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. MedicationRequest.subject.type
    Definition

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

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

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

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

    Control0..01
    BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. MedicationRequest.subject.identifier
    Definition

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

    ShortLogical reference, when literal reference is not known
    Comments

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

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

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

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

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. MedicationRequest.subject.identifier.use
    Definition

    The purpose of this identifier.

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

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

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

    Identifies the purpose for this identifier, if known .

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

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

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

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

    ShortDescription of identifier
    Comments

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

    Control0..01
    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

    TypeCodeableConcept
    Is Modifierfalse
    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()))
    40. MedicationRequest.subject.identifier.period
    Definition

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

    ShortTime period when id is/was valid for use
    Control0..01
    TypePeriod
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. MedicationRequest.subject.identifier.assigner
    Definition

    Organization that issued/manages the identifier.

    ShortOrganization that issued id (may be just text)
    Comments

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

    Control0..01
    TypeReference(Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. MedicationRequest.subject.display
    Definition

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

    ShortText alternative for the resource
    Comments

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

    Control0..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. MedicationRequest.encounter
    Definition

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

    ShortEncounter created as part of encounter/admission/stay
    Comments

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

    Control0..01
    TypeReference(Encounter)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. MedicationRequest.supportingInformation
    Definition

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

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

    Data e hora da prescrição realizada.


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

    ShortData e hora da prescriçãoWhen request was initially authored
    Control10..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. MedicationRequest.requester
    Definition

    Identifica pelo número de inscrição no Cadastro Nacional de Estabelecimentos de Saúde o Estabelecimento de Saúde que realizou a prescrição de medicamento.


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

    ShortEstabelecimento de Saúde prescritorWho/What requested the Request
    Control0..1
    TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. MedicationRequest.requester.reference
    Definition

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

    ShortLiteral reference, Relative, internal or absolute URL
    Comments

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

    Control0..01
    This element is affected by the following invariants: ref-1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. MedicationRequest.requester.type
    Definition

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

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

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

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

    Control0..01
    BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

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

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

    ShortLogical reference, when literal reference is not known
    Comments

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

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

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

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

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. MedicationRequest.requester.identifier.use
    Definition

    The purpose of this identifier.

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

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

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

    Identifies the purpose for this identifier, if known .

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

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

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

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

    ShortDescription of identifier
    Comments

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

    Control0..01
    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

    TypeCodeableConcept
    Is Modifierfalse
    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()))
    64. MedicationRequest.requester.identifier.period
    Definition

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

    ShortTime period when id is/was valid for use
    Control0..01
    TypePeriod
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    66. MedicationRequest.requester.identifier.assigner
    Definition

    Organization that issued/manages the identifier.

    ShortOrganization that issued id (may be just text)
    Comments

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

    Control0..01
    TypeReference(Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    68. MedicationRequest.requester.display
    Definition

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

    ShortText alternative for the resource
    Comments

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

    Control0..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. MedicationRequest.performer
    Definition

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

    ShortIntended performer of administration
    Control0..01
    TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    72. MedicationRequest.performerType
    Definition

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

    ShortDesired kind of performer of the medication administration
    Comments

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

    Control0..01
    BindingFor example codes, see ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-role
    (example to http://hl7.org/fhir/ValueSet/performer-role)

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

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

    Identificação e informações do profissional que realizou a prescrição de medicamento.


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

    ShortProfissional prescritorPerson who entered the request
    Control10..1
    TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRProfissional-1.0, Practitioner, PractitionerRole)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    76. MedicationRequest.recorder.reference
    Definition

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

    ShortLiteral reference, Relative, internal or absolute URL
    Comments

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

    Control0..01
    This element is affected by the following invariants: ref-1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    78. MedicationRequest.recorder.type
    Definition

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

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

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

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

    Control0..01
    BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    80. MedicationRequest.recorder.identifier
    Definition

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

    ShortLogical reference, when literal reference is not known
    Comments

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

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

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

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

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    82. MedicationRequest.recorder.identifier.use
    Definition

    The purpose of this identifier.

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

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

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

    Identifies the purpose for this identifier, if known .

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

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

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

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

    ShortDescription of identifier
    Comments

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

    Control0..01
    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

    TypeCodeableConcept
    Is Modifierfalse
    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()))
    86. MedicationRequest.recorder.identifier.period
    Definition

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

    ShortTime period when id is/was valid for use
    Control0..01
    TypePeriod
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    88. MedicationRequest.recorder.identifier.assigner
    Definition

    Organization that issued/manages the identifier.

    ShortOrganization that issued id (may be just text)
    Comments

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

    Control0..01
    TypeReference(Organization)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    90. MedicationRequest.recorder.display
    Definition

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

    ShortText alternative for the resource
    Comments

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

    Control0..01
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    92. MedicationRequest.reasonCode
    Definition

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

    ShortReason or indication for ordering or not ordering the medication
    Comments

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

    Control0..0*
    BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
    (example to http://hl7.org/fhir/ValueSet/condition-code)

    A coded concept indicating why the medication was ordered.

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

    Condition or observation that supports why the medication was ordered.

    ShortCondition or observation that supports why the prescription is being written
    Comments

    This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

    Control0..0*
    TypeReference(Condition, Observation)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    96. MedicationRequest.instantiatesCanonical
    Definition

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

    ShortInstantiates FHIR protocol or definition
    Control0..0*
    Typecanonical
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    98. MedicationRequest.instantiatesUri
    Definition

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

    ShortInstantiates external protocol or definition
    Control0..0*
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    100. MedicationRequest.basedOn
    Definition

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

    ShortWhat request fulfills
    Control0..0*
    TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    102. MedicationRequest.groupIdentifier
    Definition

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

    ShortComposite request this is part of
    Control0..01
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

    Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

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

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

    ShortOverall pattern of medication administration
    Comments

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

    Control0..01
    BindingFor example codes, see medicationRequest Course of Therapy Codeshttp://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy
    (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

    Identifies the overall pattern of medication administratio.

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

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

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

    Definição da descrição do uso do medicamento e prescrição não estruturada.


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

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

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

    ShortHow the medication should be taken
    Comments

    There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

    Control0..1*
    TypeDosage
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    112. MedicationRequest.dosageInstruction.modifierExtension
    Definition

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

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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

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

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

    ShortThe order of the dosage instructions
    Control0..01
    Typeinteger
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

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

    Descrição da prescrição e/ou posologia de medicamento de forma livre, em texto. O profissional prescritor deverá descrever todas as informações necessárias a uma prescrição e/ou posologia, entre outros elementos relevantes.


    Free text dosage instructions e.g. SIG.

    ShortPrescrição e/ou Posologia Não EstruturadaFree text dosage instructions e.g. SIG
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

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

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

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

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

    Control0..0*
    BindingFor example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes
    (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

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

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

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

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

    Orientações sobre o uso do medicamento prescrito.


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

    ShortOrientações sobre o uso do medicamentoPatient or consumer oriented instructions
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    122. MedicationRequest.dosageInstruction.timing
    Definition

    Frequência de uso do medicamento


    When medication should be administered.

    ShortFrequência de uso do medicamentoWhen medication should be administered
    Comments

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

    Control0..1
    TypeTiming
    Is Modifierfalse
    Summarytrue
    Requirements

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

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

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

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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

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

    Identifies specific times when the event occurs.

    ShortWhen the event occurs
    Control0..0*
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

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

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

    ShortWhen the event is to occur
    Control10..1
    TypeElement
    Is Modifierfalse
    Summarytrue
    Requirements

    Many timing schedules are determined by regular repetitions.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
    tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
    tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
    tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
    tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
    tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
    tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
    tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
    tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
    tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
    tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
    tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
    tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
    tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
    tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
    tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
    tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
    tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
    130. MedicationRequest.dosageInstruction.timing.repeat.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

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

      Descritor quantitativo da unidade de tempo entre doses.

      ShortExtensão - Intervalo entre doses
      Control0..1
      TypeExtension(Intervalo de Doses) (Complex Extension)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      134. MedicationRequest.dosageInstruction.timing.repeat.extension:period.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      136. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit
      Slice NameperiodUnit
      Definition

      An Extension

      ShortExtensionAdditional content defined by implementations
      Control0..1*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      138. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      140. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed ValueperiodUnit
      142. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.value[x]
      Definition

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

      ShortValue of extension
      Control10..1
      BindingThe codes SHALL be taken from For codes, see Unidade de Tempo
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeTempo)

      Define a unidade de tempo segundo o UCUM

      Typecode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      144. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.value[x].id
      Definition

      unique id for the element within a resource (for internal references)


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

      Shortxml:id (or equivalent in JSON)Unique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      146. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period
      Slice Nameperiod
      Definition

      Descritor quantitativo da unidade de tempo entre doses.

      ShortIntervalo entre dosesAdditional content defined by implementations
      Control0..1*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      148. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      150. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valueperiod
      152. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period.value[x]
      Definition

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

      ShortIntervalo entre dosesValue of extension
      Control10..1
      TypepositiveInt, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      154. MedicationRequest.dosageInstruction.timing.repeat.extension:period.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRIntervaloDoses
      156. MedicationRequest.dosageInstruction.timing.repeat.extension:period.value[x]
      Definition

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

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

      Em qual momento do dia ocorre o consumo do medicamento: Manhã, tarde, noite.

      ShortExtensão - Turno do dia
      Control0..1
      TypeExtension(Turno) (Extension Type: code)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      160. MedicationRequest.dosageInstruction.timing.repeat.extension:when.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      162. MedicationRequest.dosageInstruction.timing.repeat.extension:when.url
      Definition

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

      Shortidentifies the meaning of the extension
      Comments

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

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRTurno
      164. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
      Definition

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

      ShortLength/Range of lengths, or (Start and/or end) limits
      Control0..01
      TypeChoice of: Duration, Range, Period
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      166. MedicationRequest.dosageInstruction.timing.repeat.count
      Definition

      Número de doses a cada uso do medicamento (ex.: 1x, 2x, 3x 4x etc.)


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

      ShortRepetições de doseNumber of times to repeat
      Comments

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

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

      Repetitions may be limited by end time or total occurrences.

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

      Representa a quantidade total de doses prescritas para o medicamento: se for mais de uma, deve ser considerado como 'Dose Contínua'; do contrário, deve ser considerado como 'Dose Única'.


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

      ShortQuantidade total de dosesMaximum number of times to repeat
      Control10..1
      TypepositiveInt
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Min Value1
      Max Value2147483647
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      170. MedicationRequest.dosageInstruction.timing.repeat.duration
      Definition

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

      ShortHow long when it happens
      Comments

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

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

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

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

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

      ShortHow long when it happens (Max)
      Comments

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

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

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

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

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

      Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
      Control0..01
      BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
      (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

      A unit of time (units from UCUM).

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

      Intervalo, em horas, de cada uso do medicamento.


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

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

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

      ShortEvent occurs up to frequencyMax times per period
      Control0..01
      TypepositiveInt
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      180. MedicationRequest.dosageInstruction.timing.repeat.period
      Definition

      Descritor quantitativo da unidade de tempo entre doses.


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

      ShortIntervalo entre dosesEvent occurs frequency times per period
      Control0..01
      Typedecimal
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      182. MedicationRequest.dosageInstruction.timing.repeat.periodMax
      Definition

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

      ShortUpper limit of period (3-4 hours)
      Control0..01
      Typedecimal
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      184. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
      Definition

      Unidade de tempo entre doses (ex.: hora, dia, semana, mês etc.), em unidades UCUM.


      The units of time for the period in UCUM units.

      ShortUnidade de tempo entre dosess | min | h | d | wk | mo | a - unit of time (UCUM)
      Control0..01
      BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
      (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

      A unit of time (units from UCUM).

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

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

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

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

      Control0..0*
      BindingThe codes SHALL be taken from DaysOfWeekhttp://hl7.org/fhir/ValueSet/days-of-week|4.0.1
      (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      188. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
      Definition

      Specified time of day for action to take place.

      ShortTime of day for action
      Comments

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

      Control0..0*
      Typetime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      190. MedicationRequest.dosageInstruction.timing.repeat.when
      Definition

      Em qual momento do dia ocorre o consumo do medicamento: Manhã, tarde, noite.


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

      ShortTurno do diaCode for time period of occurrence
      Comments

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

      Control0..0*
      BindingThe codes SHALL be taken from EventTiminghttp://hl7.org/fhir/ValueSet/event-timing|4.0.1
      (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

      Real world event relating to the schedule.

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

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

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

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

      ShortMinutes from event (before or after)
      Control0..01
      TypeunsignedInt
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      194. MedicationRequest.dosageInstruction.timing.code
      Definition

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

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

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

      Control0..01
      BindingThe codes SHOULD be taken from TimingAbbreviationhttp://hl7.org/fhir/ValueSet/timing-abbreviation
      (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation)

      Code for a known / defined timing pattern.

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

      Representa a necessidade do uso contínuo do medicamento.


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

      ShortUso se necessárioTake "as needed" (for x)
      Comments

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

      Control0..1
      Typeboolean, CodeableConcept
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      198. MedicationRequest.dosageInstruction.site
      Definition

      Body site to administer to.

      ShortBody site to administer to
      Comments

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

      Control0..01
      BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes
      (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

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

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      Via de Adiministração do medicamento prescrito.


      How drug should enter body.

      ShortVia de AdministraçãoHow drug should enter body
      Control10..1
      BindingThe codes SHALL be taken from For example codes, see Via de Administração do Imunobiológicohttp://hl7.org/fhir/ValueSet/route-codes
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRViaAdministracao-1.0)

      Via de Administração


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

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      Technique for administering medication.

      ShortTechnique for administering medication
      Comments

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

      Control0..01
      BindingFor example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes
      (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

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

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      The amount of medication administered.

      ShortAmount of medication administered
      Control0..1*
      TypeElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      206. MedicationRequest.dosageInstruction.doseAndRate.type
      Definition

      Unidade de consumo do medicamento prescrito (ex.: comprimido, cápsula, aplicação, mL, gota, copo dosador, infusão etc.).


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

      ShortUnidade de consumo da doseThe kind of dose or rate specified
      Control10..1
      BindingThe codes SHALL be taken from For example codes, see Unidade de Consumohttp://hl7.org/fhir/ValueSet/dose-rate-type
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeConsumo)

      Unidade de consumo da dose


      The kind of dose or rate specified.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

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

      Control0..*
      BindingThe codes SHALL be taken from For codes, see Unidade de Consumo
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeConsumo)

      Determina a unidade de consumo

      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

      ShortVersion of the system - if relevant
      Comments

      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

      NoteThis is a business versionId, not a resource version id (see discussion)
      Control0..01
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      212. MedicationRequest.dosageInstruction.doseAndRate.type.coding.display
      Definition

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

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

      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

      ShortIf this coding was chosen directly by the user
      Comments

      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

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

      ShortPlain text representation of the concept
      Comments

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

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

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

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

      Quantidade da unidade de consumo do medicamento prescrito a cada dose.


      Amount of medication per dose.

      ShortQuantidade da DoseAmount of medication per dose
      Comments

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

      Control10..1
      TypeQuantity(SimpleQuantity), Range
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

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

      Short< | <= | >= | > - how to understand the value
      Control0..1
      BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

      How the Quantity should be understood and represented.

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

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

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

      A human-readable form of the unit.

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

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

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

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

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

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

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

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

      ShortCoded form of the unit
      Comments

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

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

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

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

      Amount of medication per unit of time.

      ShortAmount of medication per unit of time
      Comments

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

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

      Control0..01
      TypeQuantity(SimpleQuantity), Ratio, Range
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      Upper limit on medication per unit of time.

      ShortUpper limit on medication per unit of time
      Comments

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

      Control0..01
      TypeRatio
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      Quantidade máxima da dose a ser dispensada por atendimento.


      Upper limit on medication per administration.

      ShortQuantidade a ser dispensada por atendimentoUpper limit on medication per administration
      Comments

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

      Control10..1
      TypeQuantity(SimpleQuantity)
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

      Not allowed to be used in this context


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

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

      How the Quantity should be understood and represented.

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

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

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

      A human-readable form of the unit.

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

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

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

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

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

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

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

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

      ShortCoded form of the unit
      Comments

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

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

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

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

      Upper limit on medication per lifetime of the patient.

      ShortUpper limit on medication per lifetime of the patient
      Control0..01
      TypeQuantity(SimpleQuantity)
      Is Modifierfalse
      Summarytrue
      Requirements

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

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

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

      ShortAny restrictions on medication substitution
      Control0..01
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      248. MedicationRequest.priorPrescription
      Definition

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

      ShortAn order/prescription that is being replaced
      Control0..01
      TypeReference(MedicationRequest)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      250. MedicationRequest.detectedIssue
      Definition

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

      ShortClinical Issue with action
      Comments

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

      Control0..0*
      TypeReference(DetectedIssue)
      Is Modifierfalse
      Summaryfalse
      Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      252. MedicationRequest.eventHistory
      Definition

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

      ShortA list of events of interest in the lifecycle
      Comments

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

      Control0..0*
      TypeReference(Provenance)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      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.

      ShortOrdering of medication for patient or group
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate NamesPrescription, Order
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. MedicationRequest.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. MedicationRequest.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      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..0
      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..0
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      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
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      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..0
      TypeResource
      Is Modifierfalse
      Summaryfalse
      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..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. MedicationRequest.modifierExtension
      Definition

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

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

      ShortExtensions that cannot be ignored
      Comments

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

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

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

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

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

      ShortExternal ids for this request
      Comments

      This is a business identifier, not a resource identifier.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0
      TypeIdentifier
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. 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 labeled as a modifier because the status contains codes that mark the resource as not currently valid.

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

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

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. MedicationRequest.statusReason
      Definition

      Captures the reason for the current state of the MedicationRequest.

      ShortReason for current status
      Comments

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

      Control0..0
      BindingFor example codes, see medicationRequest Status Reason Codes
      (example to http://hl7.org/fhir/ValueSet/medicationrequest-status-reason)

      Identifies the reasons for a given status.

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

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

      Indicates the type of medication request (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

      ShortType of medication usage
      Comments

      The category can be used to include where the medication is expected to be consumed or other types of requests.

      Control0..0
      BindingFor example codes, see medicationRequest Category Codes
      (example to http://hl7.org/fhir/ValueSet/medicationrequest-category)

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

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

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

      Shortroutine | urgent | asap | stat
      Control0..0
      BindingThe codes SHALL be taken from RequestPriority
      (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

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

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

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

      ShortTrue if request is prohibiting action
      Comments

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

      Control0..0
      Typeboolean
      Is Modifiertrue because This element is labeled as a modifier because this element negates the request to occur (ie, this is a request for the medication not to be ordered or prescribed, etc)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. MedicationRequest.reported[x]
      Definition

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

      ShortReported rather than primary record
      Control0..0
      TypeChoice of: boolean, Reference(Patient, Practitioner, PractitionerRole, RelatedPerson, Organization)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. MedicationRequest.medication[x]
      Definition

      Identificação e informações sobre o medicamento prescrito.

      ShortMedicamento
      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
      BindingThe codes SHALL be taken from Indicativo de prescrição não estruturada ou medicamento não identificado
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRPrescricaoNaoEstruturada)

      Justificativa da ausência de dados estruturados sobre o medicamento.

      TypeChoice of: CodeableConcept, Reference(Medicamento)
      [x] NoteSee Choice of Data Types for 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()))
      36. MedicationRequest.subject
      Definition

      Quem ou o quê a composição se refere. Pode ser um indivíduo, dispositivo, grupos (de indivíduos, dispositivos etc.).

      ShortSujeito da Composição
      Comments

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

      Control1..1
      TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. MedicationRequest.subject.id
      Definition

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

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

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

      ShortAdditional content defined by implementations
      Comments

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

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

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

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

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

        Control0..0
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. MedicationRequest.subject.type
        Definition

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

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

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

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

        Control0..0
        BindingUnless not suitable, these codes SHALL be taken from ResourceType
        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

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

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

        ShortLogical reference, when literal reference is not known
        Comments

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

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

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

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

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..1
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationRequest.subject.identifier.id
        Definition

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

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

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

        ShortAdditional content defined by implementations
        Comments

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

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

          The purpose of this identifier.

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

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

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

          Identifies the purpose for this identifier, if known .

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

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

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

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

          ShortDescription of identifier
          Comments

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

          Control0..0
          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

          TypeCodeableConcept
          Is Modifierfalse
          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()))
          56. MedicationRequest.subject.identifier.system
          Definition

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

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

          Control0..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          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()))
          58. MedicationRequest.subject.identifier.value
          Definition

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

          ShortThe value that is unique
          Comments

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

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. MedicationRequest.subject.identifier.period
          Definition

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

          ShortTime period when id is/was valid for use
          Control0..0
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. MedicationRequest.subject.identifier.assigner
          Definition

          Organization that issued/manages the identifier.

          ShortOrganization that issued id (may be just text)
          Comments

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

          Control0..0
          TypeReference(Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. MedicationRequest.subject.display
          Definition

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

          ShortText alternative for the resource
          Comments

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

          Control0..0
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. MedicationRequest.encounter
          Definition

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

          ShortEncounter created as part of encounter/admission/stay
          Comments

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

          Control0..0
          TypeReference(Encounter)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. MedicationRequest.supportingInformation
          Definition

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

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

          Data e hora da prescrição realizada.

          ShortData e hora da prescrição
          Control1..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. MedicationRequest.requester
          Definition

          Identifica pelo número de inscrição no Cadastro Nacional de Estabelecimentos de Saúde o Estabelecimento de Saúde que realizou a prescrição de medicamento.

          ShortEstabelecimento de Saúde prescritor
          Control0..1
          TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. MedicationRequest.requester.id
          Definition

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

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

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

          ShortAdditional content defined by implementations
          Comments

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

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

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

            ShortLiteral reference, Relative, internal or absolute URL
            Comments

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

            Control0..0
            This element is affected by the following invariants: ref-1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. MedicationRequest.requester.type
            Definition

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

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

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

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

            Control0..0
            BindingUnless not suitable, these codes SHALL be taken from ResourceType
            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

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

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

            ShortLogical reference, when literal reference is not known
            Comments

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

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

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

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

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..1
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. MedicationRequest.requester.identifier.id
            Definition

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

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

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

            ShortAdditional content defined by implementations
            Comments

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

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

              The purpose of this identifier.

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

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

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

              Identifies the purpose for this identifier, if known .

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

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

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

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

              ShortDescription of identifier
              Comments

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

              Control0..0
              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

              TypeCodeableConcept
              Is Modifierfalse
              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()))
              92. MedicationRequest.requester.identifier.system
              Definition

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

              ShortThe namespace for the identifier value
              Comments

              Identifier.system is always case sensitive.

              Control0..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              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()))
              94. MedicationRequest.requester.identifier.value
              Definition

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

              ShortThe value that is unique
              Comments

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

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

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

              ShortTime period when id is/was valid for use
              Control0..0
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. MedicationRequest.requester.identifier.assigner
              Definition

              Organization that issued/manages the identifier.

              ShortOrganization that issued id (may be just text)
              Comments

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

              Control0..0
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              100. MedicationRequest.requester.display
              Definition

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

              ShortText alternative for the resource
              Comments

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

              Control0..0
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              102. MedicationRequest.performer
              Definition

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

              ShortIntended performer of administration
              Control0..0
              TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, CareTeam)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. MedicationRequest.performerType
              Definition

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

              ShortDesired kind of performer of the medication administration
              Comments

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

              Control0..0
              BindingFor example codes, see ProcedurePerformerRoleCodes
              (example to http://hl7.org/fhir/ValueSet/performer-role)

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

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

              Identificação e informações do profissional que realizou a prescrição de medicamento.

              ShortProfissional prescritor
              Control1..1
              TypeReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRProfissional-1.0)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              108. MedicationRequest.recorder.id
              Definition

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

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

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

              ShortAdditional content defined by implementations
              Comments

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

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

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

                ShortLiteral reference, Relative, internal or absolute URL
                Comments

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

                Control0..0
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                114. MedicationRequest.recorder.type
                Definition

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

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

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

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

                Control0..0
                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                116. MedicationRequest.recorder.identifier
                Definition

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

                ShortLogical reference, when literal reference is not known
                Comments

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

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

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

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

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..1
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. MedicationRequest.recorder.identifier.id
                Definition

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

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

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

                ShortAdditional content defined by implementations
                Comments

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

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

                  The purpose of this identifier.

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

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

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

                  Identifies the purpose for this identifier, if known .

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

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

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

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

                  ShortDescription of identifier
                  Comments

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

                  Control0..0
                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                  TypeCodeableConcept
                  Is Modifierfalse
                  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()))
                  126. MedicationRequest.recorder.identifier.system
                  Definition

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

                  ShortThe namespace for the identifier value
                  Comments

                  Identifier.system is always case sensitive.

                  Control0..1
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  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()))
                  128. MedicationRequest.recorder.identifier.value
                  Definition

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

                  ShortThe value that is unique
                  Comments

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

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Example<br/><b>General</b>:123456
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  130. MedicationRequest.recorder.identifier.period
                  Definition

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

                  ShortTime period when id is/was valid for use
                  Control0..0
                  TypePeriod
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  132. MedicationRequest.recorder.identifier.assigner
                  Definition

                  Organization that issued/manages the identifier.

                  ShortOrganization that issued id (may be just text)
                  Comments

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

                  Control0..0
                  TypeReference(Organization)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  134. MedicationRequest.recorder.display
                  Definition

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

                  ShortText alternative for the resource
                  Comments

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

                  Control0..0
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  136. MedicationRequest.reasonCode
                  Definition

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

                  ShortReason or indication for ordering or not ordering the medication
                  Comments

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

                  Control0..0
                  BindingFor example codes, see Condition/Problem/DiagnosisCodes
                  (example to http://hl7.org/fhir/ValueSet/condition-code)

                  A coded concept indicating why the medication was ordered.

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

                  Condition or observation that supports why the medication was ordered.

                  ShortCondition or observation that supports why the prescription is being written
                  Comments

                  This is a reference to a condition or observation that is the reason for the medication order. If only a code exists, use reasonCode.

                  Control0..0
                  TypeReference(Condition, Observation)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  140. MedicationRequest.instantiatesCanonical
                  Definition

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

                  ShortInstantiates FHIR protocol or definition
                  Control0..0
                  Typecanonical
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  142. MedicationRequest.instantiatesUri
                  Definition

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

                  ShortInstantiates external protocol or definition
                  Control0..0
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  144. MedicationRequest.basedOn
                  Definition

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

                  ShortWhat request fulfills
                  Control0..0
                  TypeReference(CarePlan, MedicationRequest, ServiceRequest, ImmunizationRecommendation)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  146. MedicationRequest.groupIdentifier
                  Definition

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

                  ShortComposite request this is part of
                  Control0..0
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

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

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

                  ShortOverall pattern of medication administration
                  Comments

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

                  Control0..0
                  BindingFor example codes, see medicationRequest Course of Therapy Codes
                  (example to http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy)

                  Identifies the overall pattern of medication administratio.

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

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

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

                  Definição da descrição do uso do medicamento e prescrição não estruturada.

                  ShortNotas não estruturadas
                  Control0..1
                  TypeAnnotation
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  154. MedicationRequest.dosageInstruction
                  Definition

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

                  ShortHow the medication should be taken
                  Comments

                  There are examples where a medication request may include the option of an oral dose or an Intravenous or Intramuscular dose. For example, "Ondansetron 8mg orally or IV twice a day as needed for nausea" or "Compazine® (prochlorperazine) 5-10mg PO or 25mg PR bid prn nausea or vomiting". In these cases, two medication requests would be created that could be grouped together. The decision on which dose and route of administration to use is based on the patient's condition at the time the dose is needed.

                  Control0..1
                  TypeDosage
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  156. MedicationRequest.dosageInstruction.id
                  Definition

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

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

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

                  ShortAdditional content defined by implementations
                  Comments

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

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

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

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

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

                    ShortThe order of the dosage instructions
                    Control0..0
                    Typeinteger
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

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

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

                    Descrição da prescrição e/ou posologia de medicamento de forma livre, em texto. O profissional prescritor deverá descrever todas as informações necessárias a uma prescrição e/ou posologia, entre outros elementos relevantes.

                    ShortPrescrição e/ou Posologia Não Estruturada
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

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

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

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

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

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

                    Control0..0
                    BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                    (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

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

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

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

                    Orientações sobre o uso do medicamento prescrito.

                    ShortOrientações sobre o uso do medicamento
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    170. MedicationRequest.dosageInstruction.timing
                    Definition

                    Frequência de uso do medicamento

                    ShortFrequência de uso do medicamento
                    Comments

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

                    Control0..1
                    TypeTiming
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

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

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

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

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

                    ShortAdditional content defined by implementations
                    Comments

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

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

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

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

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

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

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

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

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

                      Identifies specific times when the event occurs.

                      ShortWhen the event occurs
                      Control0..0
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

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

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

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

                      ShortWhen the event is to occur
                      Control1..1
                      TypeElement
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Many timing schedules are determined by regular repetitions.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                      tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                      tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                      tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                      tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                      tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                      tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                      tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
                      tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                      182. MedicationRequest.dosageInstruction.timing.repeat.id
                      Definition

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

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

                      An Extension

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

                        Descritor quantitativo da unidade de tempo entre doses.

                        ShortExtensão - Intervalo entre doses
                        Control0..1
                        TypeExtension(Intervalo de Doses) (Complex Extension)
                        Is Modifierfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        188. MedicationRequest.dosageInstruction.timing.repeat.extension:period.id
                        Definition

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

                        ShortUnique id for inter-element referencing
                        Control0..0
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        190. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension
                        Definition

                        An Extension

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

                          An Extension

                          ShortExtension
                          Control0..1
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          194. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..0
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          196. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

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

                            Shortidentifies the meaning of the extension
                            Comments

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

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            Fixed ValueperiodUnit
                            200. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.value[x]
                            Definition

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

                            ShortValue of extension
                            Control1..1
                            BindingThe codes SHALL be taken from Unidade de Tempo
                            (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeTempo)

                            Define a unidade de tempo segundo o UCUM

                            Typecode
                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            202. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.value[x].id
                            Definition

                            unique id for the element within a resource (for internal references)

                            Shortxml:id (or equivalent in JSON)
                            Control0..0
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            204. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:periodUnit.value[x].extension
                            Definition

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

                            Primitive value for code

                            ShortPrimitive value for code
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            208. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period
                            Slice Nameperiod
                            Definition

                            Descritor quantitativo da unidade de tempo entre doses.

                            ShortIntervalo entre doses
                            Control0..1
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            210. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..0
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            212. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period.extension
                            Definition

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

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

                              Shortidentifies the meaning of the extension
                              Comments

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

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valueperiod
                              216. MedicationRequest.dosageInstruction.timing.repeat.extension:period.extension:period.value[x]
                              Definition

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

                              ShortIntervalo entre doses
                              Control1..1
                              TypepositiveInt
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              218. MedicationRequest.dosageInstruction.timing.repeat.extension:period.url
                              Definition

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

                              Shortidentifies the meaning of the extension
                              Comments

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

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRIntervaloDoses
                              220. MedicationRequest.dosageInstruction.timing.repeat.extension:period.value[x]
                              Definition

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

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

                              Em qual momento do dia ocorre o consumo do medicamento: Manhã, tarde, noite.

                              ShortExtensão - Turno do dia
                              Control0..1
                              TypeExtension(Turno) (Extension Type: code)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              224. MedicationRequest.dosageInstruction.timing.repeat.extension:when.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..0
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              226. MedicationRequest.dosageInstruction.timing.repeat.extension:when.extension
                              Definition

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

                              ShortAdditional content defined by implementations
                              Comments

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

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

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

                                Shortidentifies the meaning of the extension
                                Comments

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

                                Control1..1
                                Typeuri
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                Fixed Valuehttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRTurno
                                230. MedicationRequest.dosageInstruction.timing.repeat.extension:when.value[x]
                                Definition

                                Em qual momento do dia ocorre o consumo do medicamento: Manhã, tarde, noite.

                                ShortTurno do dia
                                Control0..1
                                BindingThe codes SHALL be taken from Turno do dia
                                (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRTurno)

                                Define o turno do dia

                                Typecode
                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                232. MedicationRequest.dosageInstruction.timing.repeat.extension:when.value[x].id
                                Definition

                                unique id for the element within a resource (for internal references)

                                Shortxml:id (or equivalent in JSON)
                                Control0..0
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                234. MedicationRequest.dosageInstruction.timing.repeat.extension:when.value[x].extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                Primitive value for code

                                ShortPrimitive value for code
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                238. MedicationRequest.dosageInstruction.timing.repeat.bounds[x]
                                Definition

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

                                ShortLength/Range of lengths, or (Start and/or end) limits
                                Control0..0
                                TypeChoice of: Duration, Range, Period
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                240. MedicationRequest.dosageInstruction.timing.repeat.count
                                Definition

                                Número de doses a cada uso do medicamento (ex.: 1x, 2x, 3x 4x etc.)

                                ShortRepetições de dose
                                Comments

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

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

                                Repetitions may be limited by end time or total occurrences.

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

                                Representa a quantidade total de doses prescritas para o medicamento: se for mais de uma, deve ser considerado como 'Dose Contínua'; do contrário, deve ser considerado como 'Dose Única'.

                                ShortQuantidade total de doses
                                Control1..1
                                TypepositiveInt
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Min Value1
                                Max Value2147483647
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                244. MedicationRequest.dosageInstruction.timing.repeat.duration
                                Definition

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

                                ShortHow long when it happens
                                Comments

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

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

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

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

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

                                ShortHow long when it happens (Max)
                                Comments

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

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

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

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

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

                                Shorts | min | h | d | wk | mo | a - unit of time (UCUM)
                                Control0..0
                                BindingThe codes SHALL be taken from UnitsOfTime
                                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                A unit of time (units from UCUM).

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

                                Intervalo, em horas, de cada uso do medicamento.

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

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

                                ShortEvent occurs up to frequencyMax times per period
                                Control0..0
                                TypepositiveInt
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                254. MedicationRequest.dosageInstruction.timing.repeat.period
                                Definition

                                Descritor quantitativo da unidade de tempo entre doses.

                                ShortIntervalo entre doses
                                Control0..0
                                Typedecimal
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                256. MedicationRequest.dosageInstruction.timing.repeat.periodMax
                                Definition

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

                                ShortUpper limit of period (3-4 hours)
                                Control0..0
                                Typedecimal
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                258. MedicationRequest.dosageInstruction.timing.repeat.periodUnit
                                Definition

                                Unidade de tempo entre doses (ex.: hora, dia, semana, mês etc.), em unidades UCUM.

                                ShortUnidade de tempo entre doses
                                Control0..0
                                BindingThe codes SHALL be taken from UnitsOfTime
                                (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                A unit of time (units from UCUM).

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

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

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

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

                                Control0..0
                                BindingThe codes SHALL be taken from DaysOfWeek
                                (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                262. MedicationRequest.dosageInstruction.timing.repeat.timeOfDay
                                Definition

                                Specified time of day for action to take place.

                                ShortTime of day for action
                                Comments

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

                                Control0..0
                                Typetime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                264. MedicationRequest.dosageInstruction.timing.repeat.when
                                Definition

                                Em qual momento do dia ocorre o consumo do medicamento: Manhã, tarde, noite.

                                ShortTurno do dia
                                Comments

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

                                Control0..0
                                BindingThe codes SHALL be taken from EventTiming
                                (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

                                Real world event relating to the schedule.

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

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

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

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

                                ShortMinutes from event (before or after)
                                Control0..0
                                TypeunsignedInt
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                268. MedicationRequest.dosageInstruction.timing.code
                                Definition

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

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

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

                                Control0..0
                                BindingThe codes SHOULD be taken from TimingAbbreviation
                                (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation)

                                Code for a known / defined timing pattern.

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

                                Representa a necessidade do uso contínuo do medicamento.

                                ShortUso se necessário
                                Comments

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

                                Control0..1
                                Typeboolean
                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                272. MedicationRequest.dosageInstruction.site
                                Definition

                                Body site to administer to.

                                ShortBody site to administer to
                                Comments

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

                                Control0..0
                                BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

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

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Requirements

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

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

                                Via de Adiministração do medicamento prescrito.

                                ShortVia de Administração
                                Control1..1
                                BindingThe codes SHALL be taken from Via de Administração do Imunobiológico
                                (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRViaAdministracao-1.0)

                                Via de Administração

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Requirements

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

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

                                Technique for administering medication.

                                ShortTechnique for administering medication
                                Comments

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

                                Control0..0
                                BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

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

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summarytrue
                                Requirements

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

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

                                The amount of medication administered.

                                ShortAmount of medication administered
                                Control0..1
                                TypeElement
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                280. MedicationRequest.dosageInstruction.doseAndRate.id
                                Definition

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                  Unidade de consumo do medicamento prescrito (ex.: comprimido, cápsula, aplicação, mL, gota, copo dosador, infusão etc.).

                                  ShortUnidade de consumo da dose
                                  Control1..1
                                  BindingThe codes SHALL be taken from Unidade de Consumo
                                  (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeConsumo)

                                  Unidade de consumo da dose

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

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

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

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

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

                                    Control0..*
                                    BindingThe codes SHALL be taken from Unidade de Consumo
                                    (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRUnidadeConsumo)

                                    Determina a unidade de consumo

                                    TypeCoding
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

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

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

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

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

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

                                    ShortAdditional content defined by implementations
                                    Comments

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

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

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

                                      ShortIdentity of the terminology system
                                      Comments

                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

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

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

                                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                      ShortVersion of the system - if relevant
                                      Comments

                                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                      NoteThis is a business versionId, not a resource version id (see discussion)
                                      Control0..0
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      300. MedicationRequest.dosageInstruction.doseAndRate.type.coding.code
                                      Definition

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

                                      ShortSymbol in syntax defined by the system
                                      Control0..1
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to refer to a particular code in the system.

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

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

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

                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

                                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                      ShortIf this coding was chosen directly by the user
                                      Comments

                                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

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

                                      ShortPlain text representation of the concept
                                      Comments

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

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

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

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

                                      Quantidade da unidade de consumo do medicamento prescrito a cada dose.

                                      ShortQuantidade da Dose
                                      Comments

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

                                      Control1..1
                                      TypeQuantity
                                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

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

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

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

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

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

                                      ShortAdditional content defined by implementations
                                      Comments

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

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

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

                                        ShortNumerical value (with implicit precision)
                                        Comments

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

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

                                        Precision is handled implicitly in almost all cases of measurement.

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

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

                                        Short< | <= | >= | > - how to understand the value
                                        Control0..1
                                        BindingThe codes SHALL be taken from QuantityComparator
                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                        How the Quantity should be understood and represented.

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

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

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

                                        A human-readable form of the unit.

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

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

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

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

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

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

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

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

                                        ShortCoded form of the unit
                                        Comments

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

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

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

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

                                        Amount of medication per unit of time.

                                        ShortAmount of medication per unit of time
                                        Comments

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

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

                                        Control0..0
                                        TypeQuantity
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

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

                                        Upper limit on medication per unit of time.

                                        ShortUpper limit on medication per unit of time
                                        Comments

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

                                        Control0..0
                                        TypeRatio
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

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

                                        Quantidade máxima da dose a ser dispensada por atendimento.

                                        ShortQuantidade a ser dispensada por atendimento
                                        Comments

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

                                        Control1..1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

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

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

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

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

                                        ShortAdditional content defined by implementations
                                        Comments

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

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

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

                                          ShortNumerical value (with implicit precision)
                                          Comments

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

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

                                          Precision is handled implicitly in almost all cases of measurement.

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

                                          Not allowed to be used in this context

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

                                          How the Quantity should be understood and represented.

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

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

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

                                          A human-readable form of the unit.

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

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

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

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

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

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

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

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

                                          ShortCoded form of the unit
                                          Comments

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

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

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

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

                                          Upper limit on medication per lifetime of the patient.

                                          ShortUpper limit on medication per lifetime of the patient
                                          Control0..0
                                          TypeQuantity(SimpleQuantity)
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

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

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

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

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

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

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

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

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

                                          ShortFirst fill details
                                          Comments

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

                                          Control0..0
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          361. MedicationRequest.dispenseRequest.dispenseInterval
                                          Definition

                                          Intervalo, em horas, de cada uso do medicamento.

                                          ShortIntervalo em horas de cada dose do medicamento
                                          Control0..0
                                          TypeDuration
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          363. MedicationRequest.dispenseRequest.validityPeriod
                                          Definition

                                          Representa a duração do uso do medicamento prescrito.

                                          ShortDuração de uso do medicamento
                                          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.

                                          Control1..1
                                          TypePeriod
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

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

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

                                          An integer indicating the number of times, in addition to the original dispense, (aka refills or repeats) that the patient can receive the prescribed medication. Usage Notes: This integer does not include the original order dispense. This means that if an order indicates dispense 30 tablets plus "3 repeats", then the order can be dispensed a total of 4 times and the patient can receive a total of 120 tablets. A prescriber may explicitly say that zero refills are permitted after the initial dispense.

                                          ShortNumber of refills authorized
                                          Comments

                                          If displaying "number of authorized fills", add 1 to this number.

                                          Control0..0
                                          TypeunsignedInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          367. MedicationRequest.dispenseRequest.quantity
                                          Definition

                                          The amount that is to be dispensed for one fill.

                                          ShortTotal do tratamento
                                          Control0..1
                                          TypeQuantity(SimpleQuantity)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          369. MedicationRequest.dispenseRequest.quantity.id
                                          Definition

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

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

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

                                            ShortNumerical value (with implicit precision)
                                            Comments

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

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

                                            Precision is handled implicitly in almost all cases of measurement.

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

                                            Not allowed to be used in this context

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

                                            How the Quantity should be understood and represented.

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

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

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

                                            A human-readable form of the unit.

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

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

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

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

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

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

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

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

                                            ShortCoded form of the unit
                                            Comments

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

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

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            383. 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..0
                                            TypeDuration
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            385. MedicationRequest.dispenseRequest.performer
                                            Definition

                                            Indicates the intended dispensing Organization specified by the prescriber.

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

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

                                            ShortAny restrictions on medication substitution
                                            Control0..0
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            394. MedicationRequest.priorPrescription
                                            Definition

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

                                            ShortAn order/prescription that is being replaced
                                            Control0..0
                                            TypeReference(MedicationRequest)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            396. MedicationRequest.detectedIssue
                                            Definition

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

                                            ShortClinical Issue with action
                                            Comments

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

                                            Control0..0
                                            TypeReference(DetectedIssue)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            398. MedicationRequest.eventHistory
                                            Definition

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

                                            ShortA list of events of interest in the lifecycle
                                            Comments

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

                                            Control0..0
                                            TypeReference(Provenance)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))