Constellations of related FHIR Resources

Medication Structures

The structures described below are represented in the FHIR Logical table format.

This schemas in this Primer are available in FHIR Logical Tables and Shape Expressions Compact Syntax (ShExC).

MedicationOrder

Name	Type	ₙ
MedicationOrder	DomainResource
identifier	Identifier	*
status	code	?
medication[x]		1
medicationCodeableConcept	CodeableConcept
medicationReference	Reference(Medication)
patient	Reference(Patient)	?
encounter	Reference(Encounter)	?
dateWritten	dateTime	?
prescriber	Reference(Practitioner)	?
reason[x]		?
reasonCodeableConcept	CodeableConcept
reasonReference	Reference(Condition)
dateEnded	dateTime	?
reasonEnded	CodeableConcept	?
note	Annotation	*
dosageInstruction	BackboneElement	*
text	string	?
additionalInstructions	CodeableConcept	?
timing	Timing	?
asNeeded[x]		?
asNeededBoolean	boolean
asNeededCodeableConcept	CodeableConcept
site[x]		?
siteCodeableConcept	CodeableConcept
siteReference	Reference(BodySite)
route	CodeableConcept	?
method	CodeableConcept	?
dose[x]		?
doseRange	Range
doseQuantity	SimpleQuantity
rate[x]		?
rateRatio	Ratio
rateRange	Range
maxDosePerPeriod	Ratio	?
dispenseRequest	BackboneElement	?
medication[x]		?
medicationCodeableConcept	CodeableConcept
medicationReference	Reference(Medication)
validityPeriod	Period	?
numberOfRepeatsAllowed	positiveInt	?
quantity	SimpleQuantity	?
expectedSupplyDuration	Duration	?
substitution	BackboneElement	?
type	CodeableConcept	1
reason	CodeableConcept	?
priorPrescription	Reference(MedicationOrder)	?

PREFIX : <http://hl7.org/fhir/MedicationOrder.>
<MedicationOrder> {
  a                                   [fhir:MedicationOrder]?,
  :identifier                           @<Identifier>*,
  :status                               @<code>?,
  ( :medicationCodeableConcept          @<CodeableConcept> |
    :medicationReference { fhir:reference @<Medication> }
  ),
  :patient             { fhir:reference @<Patient> }?,
  :encounter           { fhir:reference @<Encounter> }?,
  :dateWritten                          $<dateTime>?,
  :prescriber          { fhir:reference @<Practitioner> }?,
  ( :reasonCodeableConcept              @<CodeableConcept> |
    :reasonReference   { fhir:reference @<Condition> }
  )?,
  :dateEnded                            $<dateTime>?,
  :reasonEnded                          @<CodeableConcept>?,
  :note                                 @<Annotation>*,
  :dosageInstruction {
    :dosageInstruction.text             @<string>?,
    :dosageInstruction.additionalInstructions
                                        @<CodeableConcept>?,
    :dosageInstruction.timing           @<Timing>?,
    ( :dosageInstruction.asNeededBoolean
                                        @<boolean> |
      :dosageInstruction.asNeededCodeableConcept
                                        @<CodeableConcept>
    )?,
    ( :dosageInstruction.siteCodeableConcept
                                        @<CodeableConcept>,
      :dosageInstruction.siteReference
                       { fhir:reference @<BodySite> }
    )?,
    :dosageInstruction.route            @<CodeableConcept>?,
    :dosageInstruction.method           @<CodeableConcept>?,
    ( :dosageInstruction.doseRange      @<Range> |
      :dosageInstruction.doseQuantity   @<SimpleQuantity>
    )?,
    ( :dosageInstruction.rateRatio      @<Ratio> |
      :dosageInstruction.rateRange      @<Range>
    )?,
    :dosageInstruction.maxDosePerPeriod @<Ratio>?
  },
  :dispenseRequest {
    ( :dispenseRequest.medicationCodeableConcept
                                        @<CodeableConcept> |
      :dispenseRequest.medicationReference
                       { fhir:reference @<Medication> }
    )?,
    :dispenseRequest.validityPeriod     @<Period>?,
    :dispenseRequest.numberOfRepeatsAllowed fhir:positiveInt?,
    :dispenseRequest.quantity           @<SimpleQuantity>?,
    :dispenseRequest.expectedSupplyDuration @<Duration>?
  }?,
  :substitution {
    :substitution.type                  @<CodeableConcept>,
    :substitution.reason                @<CodeableConcept>?
  }?,
  :priorPrescription
                       { fhir:reference @<MedicationOrder> }?
}

MedicationDispense

Name	Type	ₙ
MedicationDispense	DomainResource
identifier	Identifier	?
status	code	?
medication[x]		1
medicationCodeableConcept	CodeableConcept
medicationReference	Reference(Medication)
patient	Reference(Patient)	?
dispenser	Reference(Practitioner)	?
authorizingPrescription	Reference(MedicationOrder)	*
type	CodeableConcept	?
quantity	SimpleQuantity	?
daysSupply	SimpleQuantity	?
whenPrepared	dateTime	?
whenHandedOver	dateTime	?
destination	Reference(Location)	?
receiver	Reference(Patient \| Practitioner)	*
note	Annotation	*
dosageInstruction	BackboneElement	*
text	string	?
additionalInstructions	CodeableConcept	?
timing	Timing	?
asNeeded[x]		?
asNeededBoolean	boolean
asNeededCodeableConcept	CodeableConcept
site[x]		?
siteCodeableConcept	CodeableConcept
siteReference	Reference(BodySite)
route	CodeableConcept	?
method	CodeableConcept	?
dose[x]		?
doseRange	Range
doseQuantity	SimpleQuantity
rate[x]		?
rateRatio	Ratio
rateRange	Range
maxDosePerPeriod	Ratio	?
substitution	BackboneElement	?
type	CodeableConcept	1
reason	CodeableConcept	*
responsibleParty	Reference(Practitioner)	*

PREFIX : <http://hl7.org/fhir/MedicationDispense.>
<MedicationDispense> {
  a                                  [fhir:MedicationDispense]?,
  :identifier                             @<Identifier>?,
  :status                                 @<code>?,
  ( :medicationCodeableConcept            @<CodeableConcept> |
    :medicationReference { fhir:reference @<Medication> }
  ),
  :patient               { fhir:reference @<Patient> }?,
  :dispenser             { fhir:reference @<Practitioner> }?,
  :authorizingPrescription
                         { fhir:reference @<MedicationOrder> }*,
  :type                                   @<CodeableConcept>?,
  :quantity                               @<SimpleQuantity>?,
  :daysSupply                             @<SimpleQuantity>?,
  :whenPrepared                           $<dateTime>?,
  :whenHandedOver                         $<dateTime>?,
  :destination           { fhir:reference @<Location> }?,
  :receiver              { fhir:reference @<Patient> } OR
                         { fhir:reference @<Practitioner> }*,
  :note                                   @<Annotation>*,
  :dosageInstruction {
    :dosageInstruction.text               @<string>?,
    :dosageInstruction.additionalInstructions
                                          @<CodeableConcept>?,
    :dosageInstruction.timing             @<Timing>?,
    ( :dosageInstruction.asNeededBoolean  @<boolean> |
      :dosageInstruction.asNeededCodeableConcept
                                          @<CodeableConcept>
    )?,
    ( :dosageInstruction.siteCodeableConcept
                                          @<CodeableConcept> |
      :dosageInstruction.siteReference
                         { fhir:reference @<BodySite> }
    )?,
    :dosageInstruction.route              @<CodeableConcept>?,
    :dosageInstruction.method             @<CodeableConcept>?,
    ( :dosageInstruction.doseRange        @<Range> |
      :dosageInstruction.doseQuantity     @<SimpleQuantity>
    )?,
    ( :dosageInstruction.rateRatio        @<Ratio> |
      :dosageInstruction.rateRange        @<Range>
    )?,
    :dosageInstruction.maxDosePerPeriod   @<Ratio>?
  }*,
  :substitution {
    :substitution.type                    @<CodeableConcept>,
    :substitution.reason                  @<CodeableConcept>*,
    :substitution.responsibleParty
                         { fhir:reference @<Practitioner> }*
  }?
}

Range

Name	Type	ₙ
Range	Element
low	SimpleQuantity	?
high	SimpleQuantity	?

PREFIX : <http://hl7.org/fhir/Range.>
<Range> {
  a         [fhir:Range]?,
  :low      @<SimpleQuantity>?,
  :high     @<SimpleQuantity>?
}

Medication

Name	Type	ₙ
Medication	DomainResource
code	CodeableConcept	?
isBrand	boolean	?
manufacturer	Reference(Organization)	?
product	BackboneElement	?
form	CodeableConcept	?
ingredient	BackboneElement	*
item	Reference(Substance \| Medication)	1
amount	Ratio	?
batch	BackboneElement	*
lotNumber	string	?
expirationDate	dateTime	?
package	BackboneElement	?
container	CodeableConcept	?
content	BackboneElement	*
item	Reference(Medication)	1
amount	SimpleQuantity	?

PREFIX : <http://hl7.org/fhir/Medication.>
<Medication> {
  a                               [fhir:Medication]?,
  :code                           @<CodeableConcept>?,
  :isBrand                        @<boolean>?,
  :manufacturer  { fhir:reference @<Organization> }?,
  :product {
    :product.form                 @<CodeableConcept>?,
    :product.ingredient {
      :product.ingredient.item
                 { fhir:reference @<Substance> } OR
                 { fhir:reference @<Medication> },
      :product.ingredient.amount  @<Ratio>
    }*,
    :product.batch {
      :product.batch.lotNumber    @<string>?,
      :product.batch.expirationDate $<dateTime>?
    }*
  }?,
  :package {
    :package.container            @<CodeableConcept>?,
    :package.content {
      :package.content.item
                 { fhir:reference @<Medication> },
      :package.content.amount     @<SimpleQuantity>?
    }*
  }?
}

Timing

Name	Type	ₙ
Timing	Element
event	dateTime	*
repeat	Element	?
bounds[x]		?
boundsQuantity	Duration
boundsRange	Range
boundsPeriod	Period
count	integer	?
duration	decimal	?
durationMax	decimal	?
durationUnits	code	?
frequency	integer	?
frequencyMax	integer	?
period	decimal	?
periodMax	decimal	?
periodUnits	code	?
when	code	?
code	CodeableConcept	?

PREFIX : <http://hl7.org/fhir/Timing.>
<Timing> {
  a                          [fhir:Timing]?,
  :event                     $<dateTime>*,
  :repeat {
    ( :repeat.boundsQuantity @<Duration> |
      :repeat.boundsRange    @<Range> |
      :repeat.boundsPeriod   @<Period>
    )?,
    :repeat.count            @<int>?,
    :repeat.duration         @<decimal>?,
    :repeat.durationMax      @<decimal>?,
    :repeat.durationUnits    @<code>?,
    :repeat.frequency        @<int>?,
    :repeat.frequencyMax     @<int>?,
    :repeat.period           @<decimal>?,
    :repeat.periodMax        @<decimal>?,
    :repeat.periodUnits      @<code>?,
    :repeat.when             @<code>?
  }?,
  :code                      @<CodeableConcept>?
}

Ratio

Name	Type	ₙ
Ratio	Element
numerator	Quantity	?
denominator	Quantity	?

PREFIX : <http://hl7.org/fhir/Ratio.>
<Ratio> {
  a                [fhir:Ratio]?,
  :numerator       @<Quantity>?,
  :denominator     @<Quantity>?
}

Turtle Example

PREFIX fhir: <http://hl7.org/fhir/>
PREFIX xsd: <http://www.w3.org/2001/XMLSchema#>
<MedicationOrder/12345-67> a fhir:MedicationOrder;
   fhir:MedicationOrder.identifier   [ 
      a fhir:Identifier;
      fhir:Identifier.use    [ fhir:value "usual" ];
      fhir:Identifier.system [ fhir:value "http://myorg.example/prescriptions/" ];
      fhir:Identifier.value  [ fhir:value "12345-67" ];
   ];
   fhir:MedicationOrder.status       [ fhir:value "completed" ];
   fhir:MedicationOrder.medicationCodeableConcept _:med1;
   fhir:MedicationOrder.patient      [ fhir:reference <Patient/12345> ];
   fhir:MedicationOrder.dateWritten  "2000-11-21T15:00:00"^^xsd:dateTime ;
   fhir:MedicationOrder.prescriber   [ fhir:reference <Practitioner/98765> ];
   fhir:MedicationOrder.dateEnded    "2000-11-21"^^xsd:date ;
   fhir:MedicationOrder.dosageInstruction [
      fhir:MedicationOrder.dosageInstruction.text [ fhir:value "T1 TAB PO QID FW" ];
      fhir:MedicationOrder.dosageInstruction.timing

[
   a fhir:Timing;
   fhir:Timing.repeat [                                          # sig "QID"
     fhir:Timing.repeat.duration    [ fhir:value "1"^^xsd:decimal ];
     fhir:Timing.repeat.frequency   [ fhir:value "4"^^xsd:int ];
     fhir:Timing.repeat.periodUnits [ fhir:value "d" ]
   ]
] ;

      fhir:MedicationOrder.dosageInstruction.asNeededBoolean [ fhir:value true ];
      fhir:MedicationOrder.dosageInstruction.route        [ 
         a fhir:CodeableConcept;                                           # sig "PO"
         fhir:CodeableConcept.coding [ 
            a fhir:Coding;
            fhir:Coding.system  [ fhir:value "http://snomed.info/sct" ];
            fhir:Coding.code    [ fhir:value "394899003" ];
            fhir:Coding.display [ fhir:value "oral administration of treatment" ]
          ]
       ];
      fhir:MedicationOrder.dosageInstruction.doseQuantity [ fhir:value 1 ] # sig "T1"
   ];
.

<MedicationDispense/12345-67-89> a fhir:MedicationDispense;
   fhir:MedicationDispense.identifier     [ 
      a fhir:Identifier;
      fhir:Identifier.use    [ fhir:value "usual" ];
      fhir:Identifier.system [ fhir:value "http://myorg.example/pickups" ];
      fhir:Identifier.value  [ fhir:value "12345-67-89" ];
    ];
   fhir:MedicationDispense.status         [ fhir:value "completed" ];
   fhir:MedicationDispense.medicationCodeableConcept _:med1;
   fhir:MedicationDispense.patient        [ fhir:reference <Patient/12345> ];
   fhir:MedicationDispense.dispenser      [ fhir:reference <Practitioner/98765> ];
   fhir:MedicationDispense.authorizingPrescription
                                          [ fhir:reference <MedicationOrder/12345-67> ];
   fhir:MedicationDispense.type           [ 
      a fhir:CodeableConcept;
      fhir:CodeableConcept.coding [ 
         a fhir:Coding;
         fhir:Coding.system  [ fhir:value "http:hl7.org/fhir" ];
         fhir:Coding.code    [ fhir:value "FFP" ];
         fhir:Coding.display [ fhir:value "First Fill - Part Fill" ];
       ];
    ];
   fhir:MedicationDispense.quantity       [ 
      a fhir:Quantity;
      fhir:Quantity.value  [ fhir:value 60.0 ];
      fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
      fhir:Quantity.code   [ fhir:value "tbl" ]
    ];
   fhir:MedicationDispense.whenHandedOver "2000-11-21T15:00:00"^^xsd:dateTime ;
.

_:med1 a fhir:Medication;
   fhir:Medication.code [ 
      a fhir:CodeableConcept;
      fhir:CodeableConcept.coding [ 
         a fhir:Coding;
         fhir:Coding.system  [ fhir:value "http://myorg.example/medications/" ];
         fhir:Coding.code    [ fhir:value "8252-50580049660" ];
         fhir:Coding.display [ fhir:value "ACETAMINOPHEN" ]
       ]
    ];
   fhir:Medication.code [ 
      a fhir:CodeableConcept;
      fhir:CodeableConcept.coding [
         a fhir:Coding;
         fhir:Coding.system  [ fhir:value "http://hl7.org/fhir/sid/ndc" ];
         fhir:Coding.code    [ fhir:value "50580049660" ];
         fhir:Coding.display [ fhir:value "TYLENOL 325 MG TABLET" ]
      ]
     ]
.

<Patient/12345> a fhir:Patient;
   fhir:Patient.identifier      [ 
      a fhir:Identifier;
      fhir:Identifier.system    [ fhir:value "http://myorg.example/patients/" ];
      fhir:Identifier.value     [ fhir:value "12345" ];
    ];
   fhir:Patient.name            [ 
      a fhir:HumanName;
      fhir:HumanName.family     [ fhir:value "Patient" ];
      fhir:HumanName.given      [ fhir:value "Peter" ];
    ];
   fhir:Patient.gender          [ fhir:value "male" ];
   fhir:Patient.birthDate       [ fhir:value "1966-11-08" ];
   fhir:Patient.active          [ fhir:value true ];
.

<Practitioner/98765> a fhir:Practitioner;
   fhir:Practitioner.identifier [ 
      a fhir:Identifier;
      fhir:Identifier.use       [ fhir:value "usual" ];
      fhir:Identifier.type      [
         a fhir:CodeableConcept;
         fhir:CodeableConcept.coding [ 
            a fhir:Coding;
            fhir:Coding.system  [ fhir:value "http://hl7.org/fhir/v2/0203" ];
            fhir:Coding.code    [ fhir:value "MR" ]; # medical record number
         ]
      ];
      fhir:Identifier.system    [ fhir:value "http://myorg.example/staff/" ];
      fhir:Identifier.value     [ fhir:value "98765" ];
   ];
   fhir:Practitioner.name       [ 
      a fhir:HumanName;
      fhir:HumanName.family     [ fhir:value "Whitman" ];
      fhir:HumanName.given      [ fhir:value "Walt" ];
  ];
.

Lab Structures

DiagnosticOrder

Name	Type	ₙ
DiagnosticOrder	DomainResource
identifier	Identifier	*
status	code	?
priority	code	?
subject	Reference(Patient \| Group \| Location \| Device)	1
encounter	Reference(Encounter)	?
orderer	Reference(Practitioner)	?
reason	CodeableConcept	*
supportingInformation	Reference(Observation \| Condition \| DocumentReference)	*
specimen	Reference(Specimen)	*
event	BackboneElement	*
status	code	1
description	CodeableConcept	?
dateTime	dateTime	1
actor	Reference(Practitioner \| Device)	?
item	BackboneElement	*
code	CodeableConcept	1
specimen	Reference(Specimen)	*
bodySite	CodeableConcept	?
status	code	?
event	see event	*
note	Annotation	*

Specimen

Name	Type	ₙ
Specimen	DomainResource
identifier	Identifier	*
accessionIdentifier	Identifier	?
status	code	?
type	CodeableConcept	?
subject	Reference(Patient \| Group \| Device \| Substance)	1
receivedTime	dateTime	?
parent	Reference(Specimen)	*
collection	BackboneElement	?
collector	Reference(Practitioner)	?
comment	string	?
collected[x]		?
collectedDateTime	dateTime
collectedPeriod	Period
quantity	SimpleQuantity	?
method	CodeableConcept	?
bodySite	CodeableConcept	?
treatment	BackboneElement	*
description	string	?
procedure	CodeableConcept	?
additive	Reference(Substance)	*
container	BackboneElement	*
identifier	Identifier	*
description	string	?
type	CodeableConcept	?
capacity	SimpleQuantity	?
specimenQuantity	SimpleQuantity	?
additive[x]		?
additiveCodeableConcept	CodeableConcept
additiveReference	Reference(Substance)

DiagnosticReport

Name	Type	ₙ
DiagnosticReport	DomainResource
identifier	Identifier	*
status	code	1
category	CodeableConcept	?
code	CodeableConcept	1
subject	Reference(Patient \| Group \| Device \| Location)	1
encounter	Reference(Encounter)	?
effective[x]		1
effectiveDateTime	dateTime
effectivePeriod	Period
issued	instant	1
performer	Reference(Practitioner \| Organization)	1
request	Reference(DiagnosticOrder \| ProcedureRequest \| ReferralRequest)	*
specimen	Reference(Specimen)	*
result	Reference(Observation)	*
imagingStudy	Reference(ImagingStudy \| ImagingObjectSelection)	*
image	BackboneElement	*
comment	string	?
link	Reference(Media)	1
conclusion	string	?
codedDiagnosis	CodeableConcept	*
presentedForm	Attachment	*

Condition

Name	Type	ₙ
Condition	DomainResource
identifier	Identifier	*
patient	Reference(Patient)	1
encounter	Reference(Encounter)	?
asserter	Reference(Practitioner \| Patient)	?
dateRecorded	date	?
code	CodeableConcept	1
category	CodeableConcept	?
clinicalStatus	code	?
verificationStatus	code	1
severity	CodeableConcept	?
onset[x]		?
onsetDateTime	dateTime
onsetQuantity	Age
onsetPeriod	Period
onsetRange	Range
onsetString	string
abatement[x]		?
abatementDateTime	dateTime
abatementQuantity	Age
abatementBoolean	boolean
abatementPeriod	Period
abatementRange	Range
abatementString	string
stage	BackboneElement	?
summary	CodeableConcept	?
assessment	Reference(ClinicalImpression \| DiagnosticReport \| Observation)	*
evidence	BackboneElement	*
code	CodeableConcept	?
detail	Reference(Any)	*
bodySite	CodeableConcept	*
notes	string	?

Observation

Name	Type	ₙ
Observation	DomainResource
identifier	Identifier	*
status	code	1
category	CodeableConcept	?
code	CodeableConcept	1
subject	Reference(Patient \| Group \| Device \| Location)	?
encounter	Reference(Encounter)	?
effective[x]		?
effectiveDateTime	dateTime
effectivePeriod	Period
issued	instant	?
performer	Reference(Practitioner \| Organization \| Patient \| RelatedPerson)	*
value[x]		?
valueQuantity	Quantity
valueCodeableConcept	CodeableConcept
valueString	string
valueRange	Range
valueRatio	Ratio
valueSampledData	SampledData
valueAttachment	Attachment
valueTime	time
valueDateTime	dateTime
valuePeriod	Period
dataAbsentReason	CodeableConcept	?
interpretation	CodeableConcept	?
comment	string	?
bodySite	CodeableConcept	?
method	CodeableConcept	?
specimen	Reference(Specimen)	?
device	Reference(Device \| DeviceMetric)	?
referenceRange	BackboneElement	*
low	SimpleQuantity	?
high	SimpleQuantity	?
meaning	CodeableConcept	?
age	Range	?
text	string	?
related	BackboneElement	*
type	code	?
target	Reference(Observation \| QuestionnaireResponse)	1
component	BackboneElement	*
code	CodeableConcept	1
value[x]		?
valueQuantity	Quantity
valueCodeableConcept	CodeableConcept
valueString	string
valueRange	Range
valueRatio	Ratio
valueSampledData	SampledData
valueAttachment	Attachment
valueTime	time
valueDateTime	dateTime
valuePeriod	Period
dataAbsentReason	CodeableConcept	?
referenceRange	see referenceRange	*

Quantity

Name	Type	ₙ
Attachment	Element
contentType	code	?
language	code	?
data	base64Binary	?
url	uri	?
size	unsignedInt	?
hash	base64Binary	?
title	string	?
creation	dateTime	?

Turtle Example

<DiagnosticOrder/12345-68> a fhir:DiagnosticOrder;
   fhir:DiagnosticOrder.identifier  [ 
      a fhir:Identifier;
      fhir:Identifier.use [
          fhir:value "usual" ];
      fhir:Identifier.system [
          fhir:value "http://myorg.example/LabOrders/" ];
      fhir:Identifier.value [
          fhir:value "12345-68" ];
    ];
   fhir:DiagnosticOrder.subject     [ fhir:reference <Patient/12345> ];
   fhir:DiagnosticOrder.orderer     [ fhir:reference <Practitioner/98765> ];
   fhir:DiagnosticOrder.specimen    [ fhir:reference

[
   a fhir:Specimen;
   fhir:Specimen.status       [ fhir:value "available" ];
   fhir:Specimen.type         [ 
      a fhir:CodeableConcept;
      fhir:CodeableConcept.coding [
         a fhir:Coding;
         fhir:Coding.system [
            fhir:value "http://hl7.org/fhir/ValueSet/v2-0487"
         ];
         fhir:Coding.code     [ fhir:value "SER" ];
         fhir:Coding.display  [ fhir:value "Serum" ]
      ], [
         a fhir:Coding;
         fhir:Coding.system [
            fhir:value "http://snomed.info/sct"
         ];
         fhir:Coding.code     [ fhir:value "119364003" ];
         fhir:Coding.display  [ fhir:value "Serum specimen" ]
      ]
   ];
   fhir:Specimen.subject      [ fhir:reference <Patient/12345> ];
   fhir:Specimen.receivedTime [ fhir:value "1988-11-01T14:15:00" ];
   fhir:Specimen.container [
      fhir:Specimen.container.type [ 
         a fhir:CodeableConcept;
         fhir:CodeableConcept.coding [
            a fhir:Coding;
            fhir:Coding.system  [ fhir:value "http://cmumps.example/" ];
            fhir:Coding.code    [ fhir:value "62-319" ];
            fhir:Coding.display [ fhir:value "HIV TUBE" ]
         ]
      ]
   ]
]

   ];
   fhir:DiagnosticOrder.item [
      fhir:DiagnosticOrder.item.code [ 
         a fhir:CodeableConcept;
         fhir:CodeableConcept.coding [
            a fhir:Coding;
            fhir:Coding.system [
               fhir:value "http://myorg.example/LabTests/"
            ];
            fhir:Coding.code        [ fhir:value "60-4220" ];
            fhir:Coding.display     [ fhir:value "HIV-1 AB" ]
         ], [
            a fhir:Coding;
            fhir:Coding.system [
               fhir:value "http://myorg.example/LabMethods/"
            ];
            fhir:Coding.code        [ fhir:value "8710-2972" ];
            fhir:Coding.display [
               fhir:value "HIV INTEROPERABILITY (01JAN90)"
            ]
         ]
      ]
   ]
.

<DiagnosticReport/12345-68-001> a fhir:DiagnosticReport;
   fhir:DiagnosticReport.identifier [ 
      a fhir:Identifier;
      fhir:Identifier.use [
          fhir:value "usual" ];
      fhir:Identifier.system [
          fhir:value "http://myorg.example/LabReports/" ];
      fhir:Identifier.value [
          fhir:value "12345-68-001" ];
    ];
   fhir:DiagnosticReport.status     [ fhir:value "final" ];
   fhir:DiagnosticReport.code       [ 
      a fhir:CodeableConcept;
      fhir:CodeableConcept.coding [
         a fhir:Coding;
         fhir:Coding.system [
            fhir:value "http://myorg.example/LabTests/"
         ];
         fhir:Coding.code [ fhir:value "60-4220" ];
         fhir:Coding.display [ fhir:value "HIV-1 AB" ]
      ], [
         a fhir:Coding;
         fhir:Coding.system [
            fhir:value "http://myorg.example/LabMethods/"
         ];
         fhir:Coding.code [ fhir:value "8710-2972" ];
         fhir:Coding.display [
            fhir:value "HIV INTEROPERABILITY (01JAN90)"
         ]
      ]
   ];
   fhir:DiagnosticReport.subject    [ fhir:reference <Patient/12345> ];
   fhir:DiagnosticReport.effectiveDateTime
                                    [ fhir:value "1988-11-08T09:00:00Z" ];
   fhir:DiagnosticReport.issued     [ fhir:value "1988-11-08T09:00:00Z" ];
   fhir:DiagnosticReport.request    [ fhir:reference <DiagnosticOrder/12345-68> ];
   fhir:DiagnosticReport.result     [ fhir:reference

[
   a fhir:Observation;
   fhir:Observation.code [ 
      a fhir:CodeableConcept;
      fhir:CodeableConcept.coding [ 
         a fhir:Coding;
         fhir:Coding.system [
            fhir:value "http://myorg.example/LabResults/"
         ];
         fhir:Coding.code [ fhir:value "Negative" ]
       ]
    ]
]

]
.

<Condition/12345-68-001> a fhir:Condition;
   fhir:Condition.subject    [ fhir:reference <Patient/12345> ];
   fhir:Condition.code       [ 
      a fhir:CodeableConcept;
      fhir:CodeableConcept.coding [
         a fhir:Coding;
         fhir:Coding.system [
            fhir:value "http://myorg.example/LabTests/"
         ];
         fhir:Coding.code [ fhir:value "60-4220" ];
         fhir:Coding.display [ fhir:value "HIV-1 AB" ]
      ], [
         a fhir:Coding;
         fhir:Coding.system [
            fhir:value "http://myorg.example/LabMethods/"
         ];
         fhir:Coding.code [ fhir:value "8710-2972" ];
         fhir:Coding.display [
            fhir:value "HIV INTEROPERABILITY (01JAN90)"
         ]
      ]
   ];
   fhir:Condition.verificationStatus 
                             [ fhir:value "refuted" ];
   fhir:Condition.evidence [
      fhir:Condition.evidence.detail
                             [ fhir:reference <DiagnosticReport/12345-68-001> ]
   ]
.