Medications

Datasets

US Core 6.1.0 maps each USCDI element to FHIR.

Dataset	US Core 6.1.0 target profile(s)
`medications`	US Core MedicationRequest
`medication_dispenses`	US Core MedicationDispense

medications

One row per medication order: the prescriber's intent, with drug, dose, and indication. For most payers this file is sparse or empty — orders live in EHR and e-prescribing systems, not in claims. If your medication data comes from pharmacy claims, it belongs in medication_dispenses; populate this file only with order-level data you actually hold.

Column	Required	Format / values	Example
`record_id`	Yes	your stable key for this order; `medication_dispenses` reference it	`MED-77120`
`patient_identifier`	Yes	patient key	`MRN-4471903`
`status`	Yes	`active`, `on-hold`, `cancelled`, `completed`, `entered-in-error`, `stopped`, `draft`, `unknown` medicationrequest-status	`active`
`intent`	Yes	`proposal`, `plan`, `order`, `original-order`, `reflex-order`, `filler-order`, `instance-order`, `option` medicationrequest-intent	`order`
`medication_code`	Yes	RxNorm drug-level code, with `medication_system` (RxNorm assumed when empty) Medication Clinical Drug	`310965` ibuprofen 200 MG oral tablet
`category`	If available	`inpatient`, `outpatient`, `community`, `discharge` medicationrequest-category	`outpatient`
`reported`	Recommended	`true` / `false`	`false`
`authored_on`	Recommended	datetime	`2026-05-30`
`requester_npi`	Recommended	10 digits	`9999999991`
`encounter_id`	If applicable	`encounters` key	`ENC-9912`
`dosage_text`	Recommended	the sig, free text	`1 tab PO daily`
`dose_value`	If available	decimal	`200`
`dose_unit`	If `dose_value`	UCUM ucum-common	`mg`
`refills_allowed`	If available	integer	`3`
`dispense_quantity_value`	If available	decimal	`30`
`dispense_quantity_unit`	If `dispense_quantity_value`	UCUM ucum-common	`{tbl}`
`indication_code`	If available	SNOMED CT or ICD-10-CM code, with `indication_system` (SNOMED CT assumed when empty) us-core-condition-code	`38341003` hypertensive disorder
`is_deleted`	If retracting	`true` retracts this row	`true`

medication_code is the one coded field with no fallback: a row without it cannot become a MedicationRequest. The value set holds RxNorm codes at the prescribable-product level — a clinical or branded drug, not the bare ingredient. Send medication_system as http://www.nlm.nih.gov/research/umls/rxnorm.
status carries history: closed orders arrive as completed, stopped, or cancelled; entered-in-error retracts a record that should never have existed.
reported set to true marks an order known secondhand — reported by the member or imported from another system — rather than authored in the system that sent it.
dosage_text is the sig as written and the most valuable of the dose columns; dose_value + dose_unit are its structured counterpart, the USCDI Dose and Dose Unit of Measure elements. UCUM count units use curly braces: {tbl} tablets.
refills_allowed and the dispense_quantity_* pair describe what the order authorizes the pharmacy to dispense — refills and amount per fill.
requester_npi is the prescriber and must match a row in practitioners.

medication_dispenses

One row per fill: what the pharmacy actually handed over. For a payer this is usually the primary medication file — pharmacy claims are fill records. It carries the USCDI Medications (Fill Status) element and stays distinct from the order in medications.

Column	Required	Format / values	Example
`record_id`	Yes	your stable key for this fill	`MD-0001`
`patient_identifier`	Yes	patient key	`MRN-4471903`
`status`	Yes	`preparation`, `in-progress`, `cancelled`, `on-hold`, `completed`, `entered-in-error`, `stopped`, `declined`, `unknown` medicationdispense-status	`completed`
`medication_code`	Yes	RxNorm drug-level code, with `medication_system` (RxNorm assumed when empty) Medication Clinical Drug	`310965` ibuprofen 200 MG oral tablet
`type_code`	If available	fill type: `FF` first fill, `RF` refill, `EM` emergency supply, `UD` unit dose ActPharmacySupplyType	`RF`
`pharmacy_org_npi`	Recommended	10 digits	`9999999993`
`performer_npi`	If available	10 digits, the dispensing pharmacist	`9999999991`
`authorizing_prescription_id`	If available	`record_id` of the `medications` row	`MED-77120`
`quantity_value`	If available	decimal	`30`
`quantity_unit`	If `quantity_value`	UCUM ucum-common	`{tbl}`
`when_handed_over`	If available	datetime	`2026-06-01`
`dosage_text`	If available	the sig, free text	`1 tab PO daily`
`is_deleted`	If retracting	`true` retracts this row	`true`

status is the Fill Status element: completed for a fill picked up, in-progress or preparation for one underway, declined for one refused, entered-in-error to retract. The binding is required, so a value outside the list is rejected.
A pharmacy-claim row that carries only an NDC may send it with medication_system as http://hl7.org/fhir/sid/ndc; Payerbox crosswalks it to the RxNorm coding US Core requires.
pharmacy_org_npi is the dispensing pharmacy and performer_npi the dispensing pharmacist, when your source records one; both become MedicationDispense.performer.actor and must match a row in organizations and practitioners respectively. Pharmacy claims usually identify only the store — sending just pharmacy_org_npi is fine.
when_handed_over is when the medication left the pharmacy — for a claim, the fill date.

These resources are served by Patient Access, Provider Access, and Payer-to-Payer.