2026 US Quality Core Implementation Guide
0.5.0 - release United States of America flag

This page is part of the US Quality Core (v0.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: US Quality Core Medication

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medication Version: 0.5.0
Active as of 2026-06-05 Computable Name: USQualityCoreMedication

Profile of Medication for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

  • code: (USCDI+ Quality) (USCDI) Codes that identify this medication

Because this profile is derived from US Core, systems are also expected to support Must Support requirements and (USCDI) tagged elements inherited from US Core. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Profile Specific Implementation Guidance

Additional informational guidance for authoring CQL using this profile is provided in the CQL Authoring Usage (Informational) section of this page.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(6.1.0) Definition of a Medication
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... manufacturer Σ 0..1 Reference(US Quality Core Organization) Manufacturer of the item

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.code Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.

Constraints

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(6.1.0) Definition of a Medication
... code 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Codes that identify this medication
... manufacturer 0..1 Reference(US Quality Core Organization) Manufacturer of the item
... ingredient
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(US Quality Core Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(6.1.0) Definition of a Medication
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for this medication
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
... manufacturer Σ 0..1 Reference(US Quality Core Organization) Manufacturer of the item
... form 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 0..* BackboneElement Active or inactive ingredient
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(US Quality Core Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient present
... batch 0..1 BackboneElement Details about packaged medications
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... lotNumber 0..1 string Identifier assigned to batch
.... expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Medication.code Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.
Medication.form Base example SNOMED CT Form Codes 📦4.0.1 FHIR Std.

Constraints

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

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(6.1.0) Definition of a Medication
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... manufacturer Σ 0..1 Reference(US Quality Core Organization) Manufacturer of the item

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.code Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.

Constraints

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

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(6.1.0) Definition of a Medication
... code 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Codes that identify this medication
... manufacturer 0..1 Reference(US Quality Core Organization) Manufacturer of the item
... ingredient
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(US Quality Core Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator

doco Documentation for this format

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Medication 0..* USCoreMedicationProfile(6.1.0) Definition of a Medication
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier for this medication
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Codes that identify this medication
Binding: Medication Clinical Drug . (extensible)
... status ?!Σ 0..1 code active | inactive | entered-in-error
Binding: Medication Status Codes (required): A coded concept defining if the medication is in active use.
... manufacturer Σ 0..1 Reference(US Quality Core Organization) Manufacturer of the item
... form 0..1 CodeableConcept powder | tablets | capsule +
Binding: SNOMEDCTFormCodes (example): A coded concept defining the form of a medication.
... amount Σ 0..1 Ratio Amount of drug in package
... ingredient 0..* BackboneElement Active or inactive ingredient
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... item[x] 1..1 The actual ingredient or content
..... itemCodeableConcept CodeableConcept
..... itemReference Reference(US Quality Core Substance | US Quality Core Medication)
.... isActive 0..1 boolean Active ingredient indicator
.... strength 0..1 Ratio Quantity of ingredient present
... batch 0..1 BackboneElement Details about packaged medications
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... lotNumber 0..1 string Identifier assigned to batch
.... expirationDate 0..1 dateTime When batch will expire

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Medication.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Medication.code Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
Medication.status Base required Medication status codes 📍4.0.1 FHIR Std.
Medication.form Base example SNOMED CT Form Codes 📦4.0.1 FHIR Std.

Constraints

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

 

Other representations of profile: CSV, Excel, Schematron

Notes:

CQL Authoring Usage (Informational)

define function "GetMedicationCode"(request MedicationRequest):
  if request.medication is CodeableConcept then
    request.medication as CodeableConcept
  else
    (singleton from ([Medication] M where M.id = GetId((request.medication as Reference).reference))).code