diff --git a/src/services/guidanceresponse.service.ts b/src/services/guidanceresponse.service.ts
index d16f372b..2ee16646 100644
--- a/src/services/guidanceresponse.service.ts
+++ b/src/services/guidanceresponse.service.ts
@@ -1,7 +1,7 @@
 import { FhirUtilities } from '../fhir/utilities';
 import { GuidanceResponseUtilities } from '../fhir/guidanceResponseUtilities';
 import GuidanceResponseModel from '../lib/schemas/resources/GuidanceResponse';
-import { Parameters, Medication, Patient } from 'fhir/r4';
+import { Parameters, Medication, Patient, MedicationRequest, FhirResource } from 'fhir/r4';
 import { getCaseInfo } from '../lib/etasu';
 
 module.exports.searchById = async (args: any) => {
@@ -17,14 +17,37 @@ module.exports.create = async (args: any, req: any) => {
   return await FhirUtilities.store(resource, GuidanceResponseModel, base_version);
 };
 
-const getMedicationCode = (medication: Medication | undefined) => {
+const getMedicationCode = (
+  medication: Medication | MedicationRequest | undefined
+): string | undefined => {
   // grab the medication drug code from the Medication resource
-  let drugCode = null;
-  medication?.code?.coding?.forEach(medCode => {
-    if (medCode?.system?.endsWith('rxnorm')) {
-      drugCode = medCode?.code;
+  let drugCode;
+  if (medication?.resourceType == 'Medication') {
+    medication?.code?.coding?.forEach(medCode => {
+      if (medCode?.system?.endsWith('rxnorm')) {
+        drugCode = medCode?.code;
+      }
+    });
+  } else {
+    if (medication?.medicationCodeableConcept) {
+      medication?.medicationCodeableConcept?.coding?.forEach(medCode => {
+        if (medCode.system?.endsWith('rxnorm')) {
+          drugCode = medCode.code;
+        }
+      });
+    } else if (medication?.medicationReference) {
+      const ref = medication.medicationReference.reference;
+      if (ref?.startsWith('#')) {
+        const containedRef = ref.slice(1);
+        const match = medication.contained?.find(res => {
+          return res.id === containedRef;
+        });
+        if (match?.resourceType === 'Medication') {
+          return getMedicationCode(match);
+        }
+      }
     }
-  });
+  }
   return drugCode;
 };
 
@@ -33,12 +56,16 @@ module.exports.remsEtasu = async (args: any, context: any, logger: any) => {
 
   const parameters: Parameters = args?.resource;
   let patient: Patient | undefined;
-  let medication: Medication | undefined;
+  let medication: Medication | MedicationRequest | undefined;
 
   parameters?.parameter?.forEach(param => {
     if (param?.name === 'patient' && param?.resource?.resourceType === 'Patient') {
       patient = param.resource;
-    } else if (param?.name === 'medication' && param?.resource?.resourceType === 'Medication') {
+    } else if (
+      param?.name === 'medication' &&
+      (param?.resource?.resourceType === 'Medication' ||
+        param.resource?.resourceType === 'MedicationRequest')
+    ) {
       medication = param.resource;
     }
   });