FHIR R4 MedicationRequest · US Core MedicationRequest

MedicationRequest is produced for all three FHIR outputs, from different source data. The Patient Everything and Patient Summary bundles populate it identically to one another; Bulk Medication History is built from pharmacy claim data and differs in several places. The Stable ID and Fields sections below cover both, with a column per output.

Stable ID

Output	Recipe
Patient Everything / Summary	Derived from the patient, the prescribed date, the medication code, the drug name code, the directions (sig), the strength value and unit, the refills allowed, and the initial fill quantity.
Bulk Med History	Derived from the patient, written date, product code, drug description, directions, strength, refills, and quantity prescribed. If a subsequent request contains a record with all of the same values, it resolves to the same `MedicationRequest`.

Fields

Field	Patient Everything / Summary	Bulk Med History	Notes
`meta.profile`	1..1	1..1	Always set to the US Core MedicationRequest profile URL.
`status`	1..1	1..1	Bundles: `active` when the source medication is flagged as still active, otherwise `completed`. Bulk Med History: `completed` when the source record has a sold/fill date, otherwise `active`.
`intent`	1..1	1..1	Always `order`.
`subject`	1..1	1..1	Reference to the Patient.
`category`	1..1	1..1	Currently, always coded as `outpatient` using the medicationrequest-category system.
`medication[x]`	1..1	1..1	Bundles: either a reference to a contained Medication resource or an inline `medicationCodeableConcept` — see Medication representation. Bulk Med History: always a reference to a full Medication resource, regardless of customer configuration.
`requester`	0..1	1..1	Reference to the prescriber’s PractitionerRole. Omitted in the bundles when no prescriber is known; always populated in Bulk Med History.
`authoredOn`	0..1	0..1	The prescribed/written date, when present.
`dosageInstruction.text`	0..1	0..1	The source free-text directions (sig).
`dosageInstruction.doseAndRate.dose`	0..1	0..1	Bundles: the strength value and unit, normalized to UCUM, when the strength value is numeric. Bulk Med History: parsed from the source free-text strength field (e.g. `"10 MG"`) — only populated when that text matches a simple “number followed by unit” pattern; other formats are silently skipped.
`dispenseRequest.quantity`	0..1	0..1	Bundles: the initial fill quantity, when present. Bulk Med History: the quantity prescribed, when it is a valid number, with `code` set to the source potency unit code using the NCI Thesaurus system.
`dispenseRequest.numberOfRepeatsAllowed`	0..1	0..0	Bundles only: the source refill count plus one, reflecting that FHIR counts repeats after the initial fill differently from how the source counts authorized fills. Not populated in Bulk Med History.

In the bundles, a medication with no usable drug code — neither a coded product nor a drug name with a description — is excluded entirely rather than published without a medication.

encounter, reasonCode, priority, substitution, and dispenseRequest.validityPeriod are not populated in either output.

Medication representation

FHIR allows the drug to be given either inline as a code or as a separate Medication resource. In the Patient Everything and Patient Summary bundles, which one is used depends on customer configuration:

Customer configuration	`medication[x]`
Full `Medication` resources enabled	`medicationReference`, pointing at a Medication resource contained inside this `MedicationRequest`.
Full `Medication` resources disabled (default)	`medicationCodeableConcept`, carrying the drug coding inline.

In both cases the coding published is the same “effective” code: the source’s coded product where it carries both a code and a description, otherwise the drug name code. If neither is fully populated, whichever of the two has a description is used.

Bulk Medication History does not have this configuration switch — it always uses medicationReference against a full Medication resource, regardless of customer configuration.

Welcome

Product

FHIR

Implementation

APIs

MedicationRequest

Stable ID

Fields

Medication representation

​Stable ID

​Fields

​Medication representation

Stable ID

Fields

Medication representation