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MedicationRequest create, displaying "template non-formulary (medication)" before medication text

Swanand KulkarniMar 1 2024 — edited Mar 1 2024

I was creating a MedicationRequest in public sandbox for Dummy data patients and was successfull in creating one too.

folowing is the body :

{
resourceType: "MedicationRequest",
status: "active",
medicationCodeableConcept: {
text: "insulin lispro 100 UNT/ML Pen Injector",
coding: [
{
display: "insulin lispro 100 UNT/ML Pen Injector",
system: "http://www.nlm.nih.gov/research/umls/rxnorm",
code: "1652641",
},
],
},
subject: {
reference: "Patient/12783128",
},
reportedBoolean: true,
intent: "plan",
}

note that I've also provided correct rxnorm code.

got this returned in response:

{
"resourceType": "MedicationRequest",
"id": "414008609",
"meta": {
"versionId": "0",
"lastUpdated": "2024-03-01T10:29:08Z"
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Medication Request</b></p><p><b>Status</b>: Active</p><p><b>Intent</b>: Plan</p><p><b>Medication</b>: template non-formulary (medication) (insulin lispro 100 UNT/ML Pen Injector)</p><p><b>Dosage Instructions</b>: 0 Refill(s)</p><p><b>Patient</b>: FHIRTWO, BULKDATATWO</p><p><b>Authored On</b>: Mar 1, 2024 10:29 A.M. UTC</p></div>"
},
"extension": [
{
"valueCoding": {
"system": "http://electronichealth.se/fhir/ValueSet/prescription-format",
"code": "ELECTRONIC",
"display": "Electronic"
},
"url": "http://electronichealth.se/fhir/StructureDefinition/NLLPrescriptionFormat"
},
{
"valueCoding": {
"system": "http://ehalsomyndigheten.se/fhir/ValueSet/registration-basis-codes",
"code": "ELECTRONIC",
"display": "Electronic"
},
"url": "http://electronichealth.se/fhir/StructureDefinition/NLLRegistrationBasis"
},
{
"valueCodeableConcept": {
"text": "Does not need pharmacy verification"
},
"url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/pharmacy-verification-status"
}
],
"status": "active",
"intent": "plan",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "community",
"display": "Community",
"userSelected": false
}
]
},
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/medication-statement-category",
"code": "patientspecified",
"display": "Patient Specified",
"userSelected": false
}
]
}
],
"reportedBoolean": true,
"medicationCodeableConcept": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym",
"code": "274145179",
"display": "insulin lispro 100 UNT/ML Pen Injector",
"userSelected": true
}
],
"text": "template non-formulary (medication) (insulin lispro 100 UNT/ML Pen Injector)"
},
"subject": {
"reference": "Patient/12783128",
"display": "FHIRTWO, BULKDATATWO"
},
"encounter": {
"reference": "Encounter/97970186"
},
"authoredOn": "2024-03-01T10:29:08Z",
"requester": {
"extension": [
{
"valueCode": "unknown",
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason"
}
]
},
"courseOfTherapyType": {
"coding": [
{
"system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/4009",
"code": "2338",
"display": "Soft Stop",
"userSelected": true
},
{
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy",
"code": "continuous",
"display": "Continuous long term therapy",
"userSelected": false
}
],
"text": "Soft Stop"
},
"dosageInstruction": [
{
"extension": [
{
"valueString": "insulin lispro 100 UNT/ML Pen Injector, 0 Refill(s)",
"url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/clinical-instruction"
}
],
"text": "0 Refill(s)",
"timing": {
"repeat": {
"boundsPeriod": {
"start": "2024-03-01T10:29:00Z"
}
}
}
}
],
"dispenseRequest": {
"extension": [
{
"valueBoolean": false,
"url": "http://electronichealth.se/fhir/StructureDefinition/NLLDosePackaging"
}
],
"validityPeriod": {
"start": "2024-03-01T10:29:08Z"
},
"numberOfRepeatsAllowed": 0
}
}

Can you guys please tell me why is it displaying "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/synonym" only in codeableConcept even after using correct rxnorm code. Also this is not applicable for all medications some medication are getting created with both systems in codeableConcept.

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Added on Mar 1 2024
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