2026 US Quality Core Implementation Guide
0.5.0 - release

2026 US Quality Core Implementation Guide - Downloaded Version 0.5.0 See the Directory of published versions

## Resource Profile: US Quality Core MedicationAdministration

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationadministration | Version: 0.5.0 | Highlight text changes?
Draft as of 2026-06-05 | Computable Name: USQualityCoreMedicationAdministration

Profile of MedicationAdministration 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:

- status: (USCDI+ Quality) in-progress | on-hold | completed | entered-in-error | stopped | unknown
- medication[x]: (USCDI+ Quality) What was administered
- effective[x]: (USCDI+ Quality) Start and end time of administration
- dosage: (USCDI+ Quality)
- dosage.route: (USCDI+ Quality) Path of substance into body
- dosage.dose: (USCDI+ Quality) Amount of medication per dose

The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

### Profile Specific Implementation Guidance

To represent that a medication administration intentionally did not occur for a medical, patient, or system reason, use the US Quality Core MedicationAdministration Not Done profile.

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

Usages:

- Refer to this Profile: US Quality Core AdverseEvent
- Examples for this Profile: MedicationAdministration/cmd-example and MedicationAdministration/example
- CapabilityStatements using this Profile: US Quality Core Client CapabilityStatement and US Quality Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | MedicationAdministration | Administration of medication to a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationAdministration Status (required)
statusReason |  | 0..* | CodeableConcept | Reason administration not performed Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.
medication[x] | Σ | 1..1 |  | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Quality Core Medication) |
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] | Σ | 1..1 |  | (USCDI+ Quality) Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage | C | 0..1 | BackboneElement | (USCDI+ Quality) Constraints: mad-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
route |  | 0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred)
dose |  | 0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Non-Negative MedicationAdministration Status | 📦0.5.0 | This IG
MedicationAdministration.​statusReason | Base | example | SNOMED CT Reason Medication Not Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.18
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | 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 | MedicationAdministration | 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 | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | 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()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | MedicationAdministration | Administration of medication to a patient
status |  | 1..1 | code | (USCDI+ Quality) in-progress | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationAdministration Status (required)
statusReason |  | 0..* | CodeableConcept | Reason administration not performed
medication[x] |  | 1..1 |  | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Quality Core Medication) |
subject |  | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] |  | 1..1 | dateTime, Period | (USCDI+ Quality) Start and end time of administration
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage |  | 0..1 | BackboneElement | (USCDI+ Quality)
route |  | 0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred)
dose |  | 0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Non-Negative MedicationAdministration Status | 📦0.5.0 | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.18
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | MedicationAdministration | Administration of medication to a patient
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
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
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 |  | 0..* | Identifier | External identifier
instantiates | Σ | 0..* | uri | Instantiates protocol or definition
partOf | Σ | 0..* | Reference(MedicationAdministration | Procedure) | Part of referenced event
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationAdministration Status (required)
statusReason |  | 0..* | CodeableConcept | Reason administration not performed Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.
category |  | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
medication[x] | Σ | 1..1 |  | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Quality Core Medication) |
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
supportingInformation |  | 0..* | Reference(Resource) | Additional information to support administration
effective[x] | Σ | 1..1 |  | (USCDI+ Quality) Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | Σ | 0..* | BackboneElement | Who performed the medication administration and what they did
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
function |  | 0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) | Who performed the medication administration
reasonCode |  | 0..* | CodeableConcept | Reason administration performed Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication was administered
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
device |  | 0..* | Reference(Device) | Device used to administer
note |  | 0..* | Annotation | Information about the administration
dosage | C | 0..1 | BackboneElement | (USCDI+ Quality) Constraints: mad-1
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
text |  | 0..1 | string | Free text dosage instructions e.g. SIG
site |  | 0..1 | CodeableConcept | Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route |  | 0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred)
method |  | 0..1 | CodeableConcept | How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dose |  | 0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose
rate[x] |  | 0..1 |  | Dose quantity per unit of time
rateRatio |  |  | Ratio |
rateQuantity |  |  | Quantity(SimpleQuantity) |
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationAdministration.​status | Base | required | Non-Negative MedicationAdministration Status | 📦0.5.0 | This IG
MedicationAdministration.​statusReason | Base | example | SNOMED CT Reason Medication Not Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.18
MedicationAdministration.​performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationAdministration.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | 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 | MedicationAdministration | 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 | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | 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()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`

Summary

Structures

This structure refers to these other structures:

- US Quality Core Medication (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medication)
- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Encounter (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter)
- US Quality Core MedicationRequest (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationrequest)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | MedicationAdministration | Administration of medication to a patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationAdministration Status (required)
statusReason |  | 0..* | CodeableConcept | Reason administration not performed Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.
medication[x] | Σ | 1..1 |  | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Quality Core Medication) |
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] | Σ | 1..1 |  | (USCDI+ Quality) Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage | C | 0..1 | BackboneElement | (USCDI+ Quality) Constraints: mad-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
route |  | 0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred)
dose |  | 0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Non-Negative MedicationAdministration Status | 📦0.5.0 | This IG
MedicationAdministration.​statusReason | Base | example | SNOMED CT Reason Medication Not Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.18
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | 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 | MedicationAdministration | 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 | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | 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()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | MedicationAdministration | Administration of medication to a patient
status |  | 1..1 | code | (USCDI+ Quality) in-progress | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationAdministration Status (required)
statusReason |  | 0..* | CodeableConcept | Reason administration not performed
medication[x] |  | 1..1 |  | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Quality Core Medication) |
subject |  | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
effective[x] |  | 1..1 | dateTime, Period | (USCDI+ Quality) Start and end time of administration
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
dosage |  | 0..1 | BackboneElement | (USCDI+ Quality)
route |  | 0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred)
dose |  | 0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​status | Base | required | Non-Negative MedicationAdministration Status | 📦0.5.0 | This IG
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.18
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationAdministration |  | 0..* | MedicationAdministration | Administration of medication to a patient
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
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
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 |  | 0..* | Identifier | External identifier
instantiates | Σ | 0..* | uri | Instantiates protocol or definition
partOf | Σ | 0..* | Reference(MedicationAdministration | Procedure) | Part of referenced event
status | ?!Σ | 1..1 | code | (USCDI+ Quality) in-progress | on-hold | completed | entered-in-error | stopped | unknown Binding: Non-Negative MedicationAdministration Status (required)
statusReason |  | 0..* | CodeableConcept | Reason administration not performed Binding: SNOMEDCTReasonMedicationNotGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration is negated.
category |  | 0..1 | CodeableConcept | Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
medication[x] | Σ | 1..1 |  | (USCDI+ Quality) What was administered Binding: Medication Clinical Drug (preferred): The set of RxNorm codes to represent medications
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Quality Core Medication) |
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Who received medication
context |  | 0..1 | Reference(US Quality Core Encounter | EpisodeOfCare) | Encounter or Episode of Care administered as part of
supportingInformation |  | 0..* | Reference(Resource) | Additional information to support administration
effective[x] | Σ | 1..1 |  | (USCDI+ Quality) Start and end time of administration
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer | Σ | 0..* | BackboneElement | Who performed the medication administration and what they did
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
function |  | 0..1 | CodeableConcept | Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device) | Who performed the medication administration
reasonCode |  | 0..* | CodeableConcept | Reason administration performed Binding: ReasonMedicationGivenCodes (example): A set of codes indicating the reason why the MedicationAdministration was made.
reasonReference |  | 0..* | Reference(Condition | Observation | DiagnosticReport) | Condition or observation that supports why the medication was administered
request |  | 0..1 | Reference(US Quality Core MedicationRequest) | Request administration performed against
device |  | 0..* | Reference(Device) | Device used to administer
note |  | 0..* | Annotation | Information about the administration
dosage | C | 0..1 | BackboneElement | (USCDI+ Quality) Constraints: mad-1
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
text |  | 0..1 | string | Free text dosage instructions e.g. SIG
site |  | 0..1 | CodeableConcept | Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route |  | 0..1 | CodeableConcept | (USCDI+ Quality) Path of substance into body Binding: SNOMEDCTRouteCodes (preferred)
method |  | 0..1 | CodeableConcept | How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dose |  | 0..1 | SimpleQuantity(4.0.1) | (USCDI+ Quality) Amount of medication per dose
rate[x] |  | 0..1 |  | Dose quantity per unit of time
rateRatio |  |  | Ratio |
rateQuantity |  |  | Quantity(SimpleQuantity) |
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationAdministration.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationAdministration.​status | Base | required | Non-Negative MedicationAdministration Status | 📦0.5.0 | This IG
MedicationAdministration.​statusReason | Base | example | SNOMED CT Reason Medication Not Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​category | Base | preferred | Medication administration category codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​medication[x] | Base | preferred | Medication Clinical Drug | 📦20170601 | VSAC v0.18
MedicationAdministration.​performer.function | Base | example | Medication administration performer function codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​reasonCode | Base | example | Reason Medication Given Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationAdministration.​dosage.route | Base | preferred | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationAdministration.​dosage.method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationAdministration | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationAdministration | 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 | MedicationAdministration | 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 | MedicationAdministration | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationAdministration | 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()`
mad-1 | error | MedicationAdministration.dosage | SHALL have at least one of dosage.dose or dosage.rate[x] | `dose.exists() or rate.exists()`

Summary

Structures

This structure refers to these other structures:

- US Quality Core Medication (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medication)
- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Encounter (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter)
- US Quality Core MedicationRequest (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationrequest)

Other representations of profile: CSV, Excel, Schematron

### Notes:

#### CQL Authoring Usage (Informational)

To create an expression specifically requesting information that a MedicationAdministration intentionally did not occur for a medical, patient or system reason, use the profile USQualityCore MedicationAdministration Not Done.

The following example illustrates accessing MedicationAdministration data:

    define "Low Dose Unfractionated Heparin Administration":
      ["MedicationAdministration": medication in "Low Dose Unfractionated Heparin for VTE Prophylaxis"] VTEMedication
        where VTEMedication.status = 'completed'