Medicationdispense.profile.xml

StructureDefinition for medicationdispense

  
  
    
  
  
    
    
      
        
          
            
          
          
            
          
          
            
          
          
            
          
          
            
            
              
                
              
            
          
        
        
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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="MedicationDispense"/> 
  <meta> 
    <lastUpdated value="2019-10-24T11:53:00+11:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
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          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="The logical name of the element">Name</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Information about the use of the element">Flags</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
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            Nj6C+QmaxAek5tyAAAAAElFTkSuQmCC 
            MedicationDispense : Indicates that a medication product is to be or has been dispensed

            Nj6C+QmaxAek5tyAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Resource"/>  
            <span title="MedicationDispense : Indicates that a medication product is to be or has been dispensed
             for a named person/patient.  This includes a description of the medication product (supply)
             provided and the instructions for administering the medication.  The medication dispense
             is the result of a pharmacy system responding to a medication order.
            
          
          
            
            
          
          
          
            
          
          Dispensing a medication to a named patient
            
            
          
        

             is the result of a pharmacy system responding to a medication order.">MedicationDispense</span> 
            <a name="MedicationDispense"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <span style="padding: 3px" title="This element has or is affected by some invariants">I</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Dispensing a medication to a named patient
            <br/>  
            <span style="font-style: italic" title="mdd-1">+ whenHandedOver cannot be before whenPrepared</span> 
            <br/>  Elements defined in Ancestors: 
            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned, this

             value never changes.">id</a> , 
            <a href="resource.html#Resource" title="The metadata about the resource. This is content that is maintained by the infrastructure.

             Changes to the content may not always be associated with version changes to the resource.">meta</a> , 
            <a href="resource.html#Resource" title="A reference to a set of rules that were followed when the resource was constructed, and

             which must be understood when processing the content.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            <a href="domainresource.html#DomainResource" title="A human-readable narrative that contains a summary of the resource, and may be used to

             represent the content of the resource to a human. The narrative need not encode all the
             structured data, but is required to contain sufficient detail to make it &quot;clinically
             safe&quot; for a human to just read the narrative. Resource definitions may define what
             content should be represented in the narrative to ensure clinical safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="These resources do not have an independent existence apart from the resource that contains

             them - they cannot be identified independently, and nor can they have their own independent
             transaction scope.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition

             of the resource. In order to make the use of extensions safe and manageable, there is
             a strict set of governance  applied to the definition and use of extensions. Though any
             implementer is allowed to define an extension, there is a set of requirements that SHALL
             be met as part of the definition of the extension.">extension</a> , 
            <a href="domainresource.html#DomainResource" title="May be used to represent additional information that is not part of the basic definition

             of the resource, and that modifies the understanding of the element that contains it.
             Usually modifier elements provide negation or qualification. In order to make the use
             of extensions safe and manageable, there is a strict set of governance applied to the
             definition and use of extensions. Though any implementer is allowed to define an extension,
             there is a set of requirements that SHALL be met as part of the definition of the extension.
             Applications processing a resource are required to check for modifier extensions.">modifierExtension</a> 
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 
            MedicationDispense.identifier : Identifier assigned by the dispensing facility - this
             is an identifier assigned outside FHIR.
            
          
          
            
          
          
          
            
          
          
        

        
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          in-progress | on-hold | completed | entered-in-error | stopped
            
             (
            To be conformant, instances of this element SHALL include a code from the specified value
             set.)
          
        

        
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            MedicationDispense.patient : A link to a resource representing the person to whom the
             medication will be given.
            
          
          
            
          
          
          
            (
            )
          
          
        

        
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            (
            )
          
          
        

            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.identifier : Identifier assigned by the dispensing facility - this

             is an identifier assigned outside FHIR.">identifier</span> 
            <a name="MedicationDispense.identifier"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">External identifier
            <br/>  
          </td> 
        </tr> 

        
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC 
            MedicationDispense.authorizingPrescription : Indicates the medication order that is being
             dispensed against.
            
          
          
            
          
          
          
            (
            )
          
          
        

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 
            MedicationDispense.type : Indicates the type of dispensing event that is performed. For
             example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
            
          
          
            
          
          
          
            
          
          Trial fill, partial fill, emergency fill, etc.
            
            Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
             of Trial, Partial Fill, Emergency Fill, Samples, etc. (
            Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.)
          
        

            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.partOf : The procedure that the dispense is done because of.">partOf</span> 
            <a name="MedicationDispense.partOf"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="procedure.html">Procedure</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Event that dispense is part of
            <br/>  
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 
            MedicationDispense.quantity : The amount of medication that has been dispensed. Includes
             unit of measure.
            
          
          
            
          
          
          
            
          
          
        

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            <span title="MedicationDispense.status : A code specifying the state of the set of dispense events.">status</span> 
            <a name="MedicationDispense.status"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <span style="padding: 3px" title="This element is a modifier element">?!</span> 
            <span style="padding: 3px" title="This element is included in summaries">Σ</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">preparation | in-progress | on-hold | completed | entered-in-error | stopped
            <br/>  
            <a href="valueset-medication-dispense-status.html" title="A coded concept specifying the state of the dispense event.">MedicationDispenseStatus</a>  (
            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set">Required</a> )
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.category : Indicates type of medication dispense and where the medication

             is expected to be consumed or administered.">category</span> 
            <a name="MedicationDispense.category"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Type of medication dispense
            <br/>  
            <a href="valueset-medication-dispense-category.html" title="A code describing where the dispensed medication is expected to be consumed or administered">MedicationDispenseCategory</a>  (
            <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes

             but are not required to do so to be considered conformant.">Preferred</a> )
          </td> 
        </tr> 

        
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            MedicationDispense.medication[x] : Identifies the medication being administered. This

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            <span title="MedicationDispense.medication[x] : Identifies the medication being administered. This
             is either a link to a resource representing the details of the medication or a simple
             attribute carrying a code that identifies the medication from a known list of medications.
            
          
          
            
          
          
          
          
        

             attribute carrying a code that identifies the medication from a known list of medications.">medication[x]</span> 
            <a name="MedicationDispense.medication_x_"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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            <span style="padding: 3px" title="This element is included in summaries">Σ</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">What medication was supplied
            <br/>  
            <a href="valueset-medication-codes.html" title="A coded concept identifying which substance or product can be dispensed">SNOMED CT Medication Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The

             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
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            A concept that may be defined by a formal reference to a terminology or ontology or may
             be provided by text.
          
          
          
          
            
          
          
        

            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="A concept that may be defined by a formal reference to a terminology or ontology or may

             be provided by text.">medicationCodeableConcept</span> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
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           padding:0px 4px 0px 4px"/> 
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC medicationReference
          
          
          
          
            (
            )
          
          
        

        
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            MedicationDispense.whenPrepared : The time when the dispensed product was packaged and
             reviewed.
            
          
          
            
          
          
          
            
          
          
        

        
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            MedicationDispense.whenHandedOver : The time the dispensed product was provided to the
             patient or their representative.
            
          
          
            
          
          
          
            
          
          
        

            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  medicationReference
          </td> 
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           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="medication.html">Medication</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
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            MedicationDispense.destination : Identification of the facility/location where the medication
             was shipped to, as part of the dispense event.
            
          
          
            
          
          
          
            (
            )
          
          
        

            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.subject : A link to a resource representing the person or the group

             to whom the medication will be given.">subject</span> 
            <a name="MedicationDispense.subject"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <span style="padding: 3px" title="This element is included in summaries">Σ</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="group.html">Group</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Who the dispense is for</td> 
        </tr> 

        
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           white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA
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        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC 
            MedicationDispense.receiver : Identifies the person who picked up the medication.  This
             will usually be a patient or their caregiver, but some cases exist where it can be a healthcare
             professional.
            
          
          
            
          
          
          
            (
             | 
            )
          
          
        

            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.context : The encounter or episode of care that establishes the context

             for this event.">context</span> 
            <a name="MedicationDispense.context"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="encounter.html">Encounter</a>  | 
            <a href="episodeofcare.html">EpisodeOfCare</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Encounter / Episode associated with event</td> 
        </tr> 

        
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        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC 
            MedicationDispense.note : Extra information about the dispense that could not be conveyed
             in the other attributes.
            
          
          
            
          
          
          
            
          
          
        

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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.supportingInformation : Additional information that supports the medication

             being dispensed.">supportingInformation</span> 
            <a name="MedicationDispense.supportingInformation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Information that supports the dispensing of the medication
            <br/>  
          </td> 
        </tr> 

        
          vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
           white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA
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        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw
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            FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7 
            MedicationDispense.dosageInstruction : Indicates how the medication is to be used by the
             patient.
            
          
          
            
          
          
          
            
          
          
        

            FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/>  
            <span title="MedicationDispense.performer : Indicates who or what performed the event.  It should be

             assumed that the performer is the dispenser of the medication.">performer</span> 
            <a name="MedicationDispense.performer"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Who performed event
            <br/>  
          </td> 
        </tr> 

        
          vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
           white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA
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          uQmCC)
            data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          CZBkurQFbnaRSlAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw
            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==
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            NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
            3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav
            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC
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            8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC 
            MedicationDispense.dosageInstruction.text : Free text dosage instructions can be used
             for cases where the instructions are too complex to code. When coded instructions are
             present, the free text instructions may still be present for display to humans taking
             or administering the medication.
            
          
          
            
          
          
          
            
          
          
        

            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj

            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
            EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ
            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.performer.actor : The device, practitioner, etc. who performed the

             action.  It should be assumed that the actor is the dispenser of the medication.">actor</span> 
            <a name="MedicationDispense.performer.actor"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="organization.html">Organization</a>  | 
            <a href="patient.html">Patient</a>  | 
            <a href="device.html">Device</a>  | 
            <a href="relatedperson.html">RelatedPerson</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Individual who was performing</td> 
        </tr> 

        
          vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
           white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA
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          uQmCC)
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        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          sPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB

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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj

            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.performer.onBehalfOf : The organization the device or practitioner

             was acting on behalf of.">onBehalfOf</span> 
            <a name="MedicationDispense.performer.onBehalfOf"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="organization.html">Organization</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Organization organization was acting for</td> 
        </tr> 


        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          sPVYVAgIJrA/sAAAAASUVORK5CYII=)">
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB
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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj

            wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.authorizingPrescription : Indicates the medication order that is being

             dispensed against.">authorizingPrescription</span> 
            <a name="MedicationDispense.authorizingPrescription"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="medicationrequest.html">MedicationRequest</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Medication order that authorizes the dispense
            <br/>  
          </td> 
        </tr> 


        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 
            MedicationDispense.dosageInstruction.additionalInstructions : Additional instructions
             such as &quot;Swallow with plenty of water&quot; which may or may not be coded.
            
          
          
            
          
          
          
            
          
          
        

            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.type : Indicates the type of dispensing event that is performed. For

             example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.">type</span> 
            <a name="MedicationDispense.type"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Trial fill, partial fill, emergency fill, etc.
            <br/>  
            <a href="v3/ActPharmacySupplyType/vs.html" title="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion

             of Trial, Partial Fill, Emergency Fill, Samples, etc.">ActPharmacySupplyType</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The

             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 
            MedicationDispense.dosageInstruction.timing : The timing schedule for giving the medication
             to the patient.  The Schedule data type allows many different expressions.  For example,
             &quot;Every  8 hours&quot;; &quot;Three times a day&quot;; &quot;1/2 an hour before breakfast
             for 10 days from 23-Dec 2011:&quot;;  &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;.
            
          
          
            
          
          
          
            
          
          
        

        
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            MedicationDispense.dosageInstruction.asNeeded[x] : Indicates whether the Medication is
             only taken when needed within a specific dosing schedule (Boolean option), or it indicates
             the precondition for taking the Medication (CodeableConcept).    Specifically if 'boolean'
             datatype is selected, then the following logic applies:  If set to True, this indicates
             that the medication is only taken when needed, within the specified schedule.
            
          
          
            
          
          
          
          
        

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            <span title="MedicationDispense.quantity : The amount of medication that has been dispensed. Includes

             unit of measure.">quantity</span> 
            <a name="MedicationDispense.quantity"> </a> 
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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        </tr> 

        
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            A concept that may be defined by a formal reference to a terminology or ontology or may
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            <span title="MedicationDispense.daysSupply : The amount of medication expressed as a timing amount.">daysSupply</span> 
            <a name="MedicationDispense.daysSupply"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Amount of medication expressed as a timing amount</td> 
        </tr> 

        
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            MedicationDispense.dosageInstruction.site[x] : A coded specification of the anatomic site
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          Body site to administer to
            
             (
            Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.)
          
        

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            <span title="MedicationDispense.whenPrepared : The time when the dispensed product was packaged and

             reviewed.">whenPrepared</span> 
            <a name="MedicationDispense.whenPrepared"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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            <span style="padding: 3px" title="This element is included in summaries">Σ</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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        </tr> 

        
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            A concept that may be defined by a formal reference to a terminology or ontology or may
             be provided by text.
          
          
          
          
            
          
          
        

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            <span title="MedicationDispense.whenHandedOver : The time the dispensed product was provided to the

             patient or their representative.">whenHandedOver</span> 
            <a name="MedicationDispense.whenHandedOver"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">When product was given out</td> 
        </tr> 

        
          vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px;
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC siteReference
          
          
          
          
            (
            )
          
          
        

            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.destination : Identification of the facility/location where the medication

             was shipped to, as part of the dispense event.">destination</span> 
            <a name="MedicationDispense.destination"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="location.html">Location</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Where the medication was sent</td> 
        </tr> 

        
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            MedicationDispense.dosageInstruction.route : A code specifying the route or physiological
             path of administration of a therapeutic agent into or onto a subject.
            
          
          
            
          
          
          
            
          
          How drug should enter body
            
            A coded concept describing the route or physiological path of administration of a therapeutic
             agent into or onto the body of a subject (
            Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.)
          
        

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            <span title="MedicationDispense.receiver : Identifies the person who picked up the medication.  This

             will usually be a patient or their caregiver, but some cases exist where it can be a healthcare
             professional.">receiver</span> 
            <a name="MedicationDispense.receiver"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="practitioner.html">Practitioner</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Who collected the medication
            <br/>  
          </td> 
        </tr> 

        
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            MedicationDispense.dosageInstruction.method : A coded value indicating the method by which
             the medication is intended to be or was introduced into or on the body.
            
          
          
            
          
          
          
            
          
          
        

        
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            MedicationDispense.dosageInstruction.dose[x] : The amount of therapeutic or other substance
             given at one administration event.
            
          
          
            
          
          
          
          
        

            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.note : Extra information about the dispense that could not be conveyed

             in the other attributes.">note</span> 
            <a name="MedicationDispense.note"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#Annotation">Annotation</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Information about the dispense
            <br/>  
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.dosageInstruction : Indicates how the medication is to be used by the

             patient.">dosageInstruction</span> 
            <a name="MedicationDispense.dosageInstruction"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="dosage.html#Dosage">Dosage</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">How the medication is to be used by the patient or administered by the caregiver
            <br/>  
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 doseQuantity
          
          
          
          
            
          
          
        

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            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB

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            FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/>  
            <span title="MedicationDispense.substitution : Indicates whether or not substitution was made as part

             of the dispense.  In some cases substitution will be expected but does not happen, in
             other cases substitution is not expected but does happen.  This block explains what substitution
             did or did not happen and why.  If nothing is specified, substitution was not done.">substitution</span> 
            <a name="MedicationDispense.substitution"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Whether a substitution was performed on the dispense</td> 
        </tr> 

        
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            MedicationDispense.dosageInstruction.rate[x] : Identifies the speed with which the medication
             was or will be introduced into the patient. Typically the rate for an infusion e.g. 100
             ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500
             ml per 2 hours.   Currently we do not specify a default of '1' in the denominator, but
             this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.
            
          
          
            
          
          
          
          
        

            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW

            XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i
            8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  
            <span title="MedicationDispense.substitution.wasSubstituted : True if the dispenser dispensed a different

             drug or product from what was prescribed.">wasSubstituted</span> 
            <a name="MedicationDispense.substitution.wasSubstituted"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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            <a href="datatypes.html#boolean">boolean</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Whether a substitution was or was not performed on the dispense</td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.substitution.type : A code signifying whether a different drug was

             dispensed from what was prescribed.">type</span> 
            <a name="MedicationDispense.substitution.type"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Code signifying whether a different drug was dispensed from what was prescribed
            <br/>  
            <a href="v3/ActSubstanceAdminSubstitutionCode/vs.html" title="A coded concept describing whether a different medicinal product may be dispensed other

             than the product as specified exactly in the prescription">ActSubstanceAdminSubstitutionCode</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The

             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.substitution.reason : Indicates the reason for the substitution of

             (or lack of substitution) from what was prescribed.">reason</span> 
            <a name="MedicationDispense.substitution.reason"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Why was substitution made
            <br/>  
            <a href="v3/SubstanceAdminSubstitutionReason/vs.html" title="A coded concept describing the reason that a different medication should (or should not)

             be substituted from what was prescribed">SubstanceAdminSubstitutionReason</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The

             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
            <br/>  
          </td> 
        </tr> 

        
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            MedicationDispense.dosageInstruction.maxDosePerPeriod : The maximum total quantity of
             a therapeutic substance that may be administered to a subject over the period of time,
              e.g. 1000mg in 24 hours.
            
          
          
            
          
          
          
            
          
          
        

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            <span title="MedicationDispense.substitution.responsibleParty : The person or organization that has

             primary responsibility for the substitution.">responsibleParty</span> 
            <a name="MedicationDispense.substitution.responsibleParty"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="practitioner.html">Practitioner</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Who is responsible for the substitution
            <br/>  
          </td> 
        </tr> 

        
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            FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7 
            MedicationDispense.substitution : Indicates whether or not substitution was made as part
             of the dispense.  In some cases substitution will be expected but does not happen, in
             other cases substitution is not expected but does happen.  This block explains what substitution
             did or did not happen and why.
            
          
          
            
          
          
          
            
          
          
        

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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.detectedIssue : Indicates an actual or potential clinical issue with

             or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug
             interaction, duplicate therapy, dosage alert etc.">detectedIssue</span> 
            <a name="MedicationDispense.detectedIssue"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="detectedissue.html">DetectedIssue</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Clinical issue with action
            <br/>  
          </td> 
        </tr> 

        
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 
            MedicationDispense.substitution.type : A code signifying whether a different drug was
             dispensed from what was prescribed.
            
          
          
            
          
          
          
            
          
          Type of substitution
            
            A coded concept describing whether a different medicinal product may be dispensed other
             than the product as specified exactly in the prescription (
            Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.)
          
        

            7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW

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            8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/>  
            <span title="MedicationDispense.notDone : True if the dispense was not performed for some reason.">notDone</span> 
            <a name="MedicationDispense.notDone"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="datatypes.html#boolean">boolean</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Whether the dispense was or was not performed</td> 
        </tr> 

        
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           white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA
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        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
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            <span title="MedicationDispense.notDoneReason[x] : Indicates the reason why a dispense was not performed.">notDoneReason[x]</span> 
            <a name="MedicationDispense.notDoneReason_x_"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">Why a dispense was not performed</td> 
        </tr> 


        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
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            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7 
            MedicationDispense.substitution.reason : Indicates the reason for the substitution of
             (or lack of substitution) from what was prescribed.
            
          
          
            
          
          
          
            
          
          Why was substitution made
            
            A coded concept describing the reason that a different medication should (or should not)
             be substituted from what was prescribed (
            Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.)
          
        

            FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="A concept that may be defined by a formal reference to a terminology or ontology or may

             be provided by text.">notDoneReasonCodeableConcept</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

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            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
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            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC 
            MedicationDispense.substitution.responsibleParty : The person or organization that has
             primary responsibility for the substitution.
            
          
          
            
          
          
          
            (
            )
          
          
        

            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  notDoneReasonReference
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="detectedissue.html">DetectedIssue</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
        </tr> 

        
          
            
            
               Documentation for this format
            
          
        
      
    
  
  
    
  
  
  
  
  
  
    
      
      
    
  
  
    
      
      
    
  
  
  
  
  
    
    
    
  
  
    
    
    
  
  
    
    
    
  
  
  
  
  
    
      
      
      Indicates that a medication product is to be or has been dispensed for a named person/patient.

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KG
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          AASUVORK5CYII=)">
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            EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ
            KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.eventHistory : A summary of the events of interest that have occurred,

             such as when the dispense was verified.">eventHistory</span> 
            <a name="MedicationDispense.eventHistory"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">
            <a href="references.html">Reference</a> (
            <a href="provenance.html">Provenance</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;

           padding:0px 4px 0px 4px">A list of releveant lifecycle events
            <br/>  
          </td> 
        </tr> 


        <tr> 
          <td class="hierarchy" colspan="5">
            <br/>  
            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/>  Documentation for this format
            </a> 
          </td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="phx"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> 
  <name value="MedicationDispense"/> 
  <status value="draft"/> 
  <date value="2019-10-24T11:53:00+11:00"/> 
  <publisher value="Health Level Seven International (Pharmacy)"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/medication/index.cfm"/> 
    </telecom> 
  </contact> 
  <description value="Base StructureDefinition for MedicationDispense Resource"/> 
  <fhirVersion value="3.0.2"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Mapping"/> 
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  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
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  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/w5"/> 
    <name value="W5 Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 v2 Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="MedicationDispense"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
  <derivation value="specialization"/> 
  <snapshot> 
    <element id="MedicationDispense">
      <path value="MedicationDispense"/> 
      <short value="Dispensing a medication to a named patient"/> 
      <definition value="Indicates that a medication product is to be or has been dispensed for a named person/patient.
        This includes a description of the medication product (supply) provided and the instructions
       for administering the medication.  The medication dispense is the result of a pharmacy
       system responding to a medication order.
      
      
      
        
      
      
        
        
        
        not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va
        lue &gt;= f:whenPrepared/@value)
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes.
      The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID.
      
      
      
        
      
      
    
    
      
      
      The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource.
      
      
      
        
      
      
    
    
      
      
      A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content.
      Asserting this rule set restricts the content to be only understood by a limited set of

       system responding to a medication order."/> 
      <comment value="The WG will be updating the MedicationDispense resource  to adjust each affected resource

       to align with the workflow pattern (see workflow.html)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <xpath value="not(parent::f:contained and f:contained)"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-1"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/> 
        <expression value="contained.text.empty()"/> 
        <xpath value="not(parent::f:contained and f:text)"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or

         a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere

         in the resource"/> 
        <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()"/> 
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f

        :reference/@value=concat('#', $id))]))"/> 
        <source value="DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="mdd-1"/> 
        <severity value="error"/> 
        <human value="whenHandedOver cannot be before whenPrepared"/> 
        <expression value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver &gt;= whenPrepared"/> 
        <xpath value="not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va

        lue &gt;= f:whenPrepared/@value)"/> 
      </constraint> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="..Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Supply[moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.id">
      <path value="MedicationDispense.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this

       value never changes."/> 
      <comment value="The only time that a resource does not have an id is when it is being submitted to the

       server using a create operation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="id"/> 
      </type> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationDispense.meta">
      <path value="MedicationDispense.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.

       Changes to the content may not always be associated with version changes to the resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationDispense.implicitRules">
      <path value="MedicationDispense.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and

       which must be understood when processing the content."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element as much as possible.
      
      
      
        
      
      
      
    
    
      
      
      
      Language is provided to support indexing and accessibility (typically, services such as

       and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies it's meaning or interpretation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationDispense.language">
      <path value="MedicationDispense.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute).
      
      
      
        
      
      
        
        
        
      
    
    
      
      
      A human-readable narrative that contains a summary of the resource, and may be used to

       between xml:lang and the html lang attribute)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference> 
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/> 
          </valueReference> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="A human language."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/languages"/> 
        </valueSetReference> 
      </binding> 
    </element> 
    <element id="MedicationDispense.text">
      <path value="MedicationDispense.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety.
      Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative.
      
      
      
      
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      These resources do not have an independent existence apart from the resource that contains

       content should be represented in the narrative to ensure clinical safety."/> 
      <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have

       a narrative. In some cases, a resource may only have text with little or no additional
       discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary
       for data from legacy systems where information is captured as a &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded in formation is added
       later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-1"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.contained">
      <path value="MedicationDispense.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope.
      This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again.
      
      
      
      
      
      
        
      
      
        
        
      
    
    
      
      
      May be used to represent additional information that is not part of the basic definition

       transaction scope."/> 
      <comment value="This should never be done when the content can be identified properly, as once identification

       is lost, it is extremely difficult (and context dependent) to restore it again."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.extension">
      <path value="MedicationDispense.extension"/> 
      <short value="Additional Content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension.
      There can be no stigma associated with the use of extensions by any application, project,

       be met as part of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone.
      
      
      
      
      
        
      
      
        
        
      
    
    
      
      
      May be used to represent additional information that is not part of the basic definition

       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.modifierExtension">
      <path value="MedicationDispense.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. In order to make the use
       of extensions safe and manageable, there is a strict set of governance applied to the
       definition and use of extensions. Though any implementer is allowed to define an extension,
       there is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions.
      There can be no stigma associated with the use of extensions by any application, project,

       Applications processing a resource are required to check for modifier extensions."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone.
      
      
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      Identifier assigned by the dispensing facility - this is an identifier assigned outside
       FHIR.
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
      
        
        
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
      
        
        
      
      
      
        
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        RXD-10-Dispensing Provider / PRT-5-Participation Person: PRT-4-Participation='DP' (RXD-10
         is deprecated)
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
       of Trial, Partial Fill, Emergency Fill, Samples, etc.
      
      
      
        
      
      
      
        
        Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
         of Trial, Partial Fill, Emergency Fill, Samples, etc.
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense
         Units.name of coding system
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
    
    
      
      
      Identifies the medication being administered. This is either a link to a resource representing

       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.identifier">
      <path value="MedicationDispense.identifier"/> 
      <short value="External identifier"/> 
      <definition value="Identifier assigned by the dispensing facility - this is an identifier assigned outside

       FHIR."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="id"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.partOf">
      <path value="MedicationDispense.partOf"/> 
      <short value="Event that dispense is part of"/> 
      <definition value="The procedure that the dispense is done because of."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…part of"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/> 
      <short value="preparation | in-progress | on-hold | completed | entered-in-error | stopped"/> 
      <definition value="A code specifying the state of the set of dispense events."/> 
      <comment value="This element is labeled as a modifier because the status contains codes that mark the

       resource as not currently valid."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="A coded concept specifying the state of the dispense event."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/medication-dispense-status"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="status"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.category">
      <path value="MedicationDispense.category"/> 
      <short value="Type of medication dispense"/> 
      <definition value="Indicates type of medication dispense and where the medication is expected to be consumed

       or administered."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="A code describing where the dispensed medication is expected to be consumed or administered"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/medication-dispense-category"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type

         of medication dispense&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/> 
      <short value="What medication was supplied"/> 
      <definition value="Identifies the medication being administered. This is either a link to a resource representing
       the details of the medication or a simple attribute carrying a code that identifies the
       medication from a known list of medications.
      If only a code is specified, then it needs to be a code for a specific product.  If more
       information is required, then the use of the medication resource is recommended.  Note:
       do not use Medication.name to describe the dispensed medication. When the only available
       information is a text description of the medication, Medication.code.text should be used.
      
      
      
        
      
      
        
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      Identification of the facility/location where the medication was shipped to, as part of
       the dispense event.
      
      
      
        
        
      
      
      
        
        RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy
         Address
      
      
        
        
      
    
    
      
      
      Identifies the person who picked up the medication.  This will usually be a patient or
       their caregiver, but some cases exist where it can be a healthcare professional.
      
      
      
        
        
      
      
        
        
      
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      
      When the dose or rate is intended to change over the entire administration period (e.g.
       Tapering dose prescriptions), multiple instances of dosage instructions will need to be
       supplied to convey the different doses/rates.
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      
      
      
      
      
        
      
      
        
        
      
    
    
      
      
      May be used to represent additional information that is not part of the basic definition

       medication from a known list of medications."/> 
      <comment value="If only a code is specified, then it needs to be a code for a specific product. If more

       information is required, then the use of the medication resource is recommended.  For
       example if you require form or lot number, then you must reference the Medication resource. ."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
      </type> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying which substance or product can be dispensed"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/medication-codes"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…code"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-2-Dispense/Give Code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRD].role"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="what"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.subject">
      <path value="MedicationDispense.subject"/> 
      <short value="Who the dispense is for"/> 
      <definition value="A link to a resource representing the person or the group to whom the medication will

       be given."/> 
      <comment value="SubstanceAdministration-&gt;subject-&gt;Patient."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…subject"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3-Patient ID List"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="who.focus"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.context">
      <path value="MedicationDispense.context"/> 
      <short value="Encounter / Episode associated with event"/> 
      <definition value="The encounter or episode of care that establishes the context for this event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type

         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.supportingInformation">
      <path value="MedicationDispense.supportingInformation"/> 
      <short value="Information that supports the dispensing of the medication"/> 
      <definition value="Additional information that supports the medication being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal

         with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of
         the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS,
         RQO, PRP, APT, ARQ, GOL)]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="context"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer">
      <path value="MedicationDispense.performer"/> 
      <short value="Who performed event"/> 
      <definition value="Indicates who or what performed the event.  It should be assumed that the performer is

       the dispenser of the medication."/> 
      <comment value="The performer will be reviewed as part of STU4."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…performer"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRF]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.id">
      <path value="MedicationDispense.performer.id"/> 
      <representation value="xmlAttr"/> 
      <short value="xml:id (or equivalent in JSON)"/> 
      <definition value="unique id for the element within a resource (for internal references). This may be any

       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.extension">
      <path value="MedicationDispense.performer.extension"/> 
      <short value="Additional Content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension.
      There can be no stigma associated with the use of extensions by any application, project,

       be met as part of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone.
      
      
      
      
      
        
      
      
        
        
      
    
    
      
      
      May be used to represent additional information that is not part of the basic definition

       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.modifierExtension">
      <path value="MedicationDispense.performer.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions.
      There can be no stigma associated with the use of extensions by any application, project,

       processing a resource are required to check for modifier extensions."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone.
      
      
      
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      Free text dosage instructions can be used for cases where the instructions are too complex
       to code. When coded instructions are present, the free text instructions may still be
       present for display to humans taking or administering the medication.
      
      
      
        
      
      
    
    
      
      
      Additional instructions such as &quot;Swallow with plenty of water&quot; which may or
       may not be coded.
      
      
      
        
      
      
      
        
        Codes identifying additional instructions such as &quot;take with water&quot; or &quot;avoid
         operating heavy machinery&quot;
      
      
        
        
      
    
    
      
      
      The timing schedule for giving the medication to the patient.  The Schedule data type
       allows many different expressions.  For example, &quot;Every  8 hours&quot;; &quot;Three
       times a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;;
        &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;.
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      Indicates whether the Medication is only taken when needed within a specific dosing schedule
       (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
          Specifically if 'boolean' datatype is selected, then the following logic applies: 
       If set to True, this indicates that the medication is only taken when needed, within the
       specified schedule.
      
      
      
        
      
      
        
      
      
      
        
        A coded concept identifying the precondition that should be met or evaluated prior to
         consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30
         minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc.
      
      
        
        boolean: .outboundRelationship[typeCode=PRCN].negationInd (inversed - so negationInd =
         true means asNeeded=false  CodeableConcept: .outboundRelationship[typCode=PRCN].target[classCode=OBS
        , moodCode=EVN, isCriterionInd=true, code=&quot;Assertion&quot;].value
      
    
    
      
      
      
      
      
      
        
      
      
        
        
      
      
      
        
        
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      A code specifying the route or physiological path of administration of a therapeutic agent
       into or onto a subject.
      
      
      
        
      
      
      
        
        A coded concept describing the route or physiological path of administration of a therapeutic
         agent into or onto the body of a subject
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      A coded value indicating the method by which the medication is intended to be or was introduced
       into or on the body.
      This attribute will most often NOT be populated.  It is most commonly used for injections.
        For example, Slow Push, Deep IV.  One of the reasons this attribute is not used often,
       is that the method is often pre-coordinated with the route and/or form of administration.
        This means the codes used in route or form may pre-coordinate the method in the route
       code or the form code.  The implementation decision about what coding system to use for
       route or form code will determine how frequently the method code will be populated e.g.
       if route or form code pre-coordinate method code, then this attribute will not be populated
       often; if there is no pre-coordination then method code may  be used frequently.
      
      
      
        
      
      
      
        
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      Note that this specifies the quantity of the specified medication, not the quantity of
       active ingredient(s).  The prescribed strength can be calculated by multiplying the doseQuantity
       by the strength of each active ingredient in the prescribed Medication. If the administration
       is not intended to be instantaneous (rate is present or timing has a duration), this can
       be specified to convey the total amount to be administered over the period of time as
       indicated by the schedule.
      
      
      
        
      
      
        
        
      
      
      
        
        RXE-23-Give Rate Amount / RXE-24.1-Give Rate Units.code / RXE-24.3-Give Rate Units.name
         of coding system
      
      
        
        
      
    
    
      
      
      Identifies the speed with which the medication was or will be introduced into the patient.
       Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed
       as a rate per unit of time e.g. 500 ml per 2 hours.   Currently we do not specify a default
       of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or
       200 mcg/1 minute; 1 liter/8 hours.
      
      
      
        
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      The maximum total quantity of a therapeutic substance that may be administered to a subject
       over the period of time,  e.g. 1000mg in 24 hours.
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      Indicates whether or not substitution was made as part of the dispense.  In some cases

       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.actor">
      <path value="MedicationDispense.performer.actor"/> 
      <short value="Individual who was performing"/> 
      <definition value="The device, practitioner, etc. who performed the action.  It should be assumed that the

       actor is the dispenser of the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="….actor"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.onBehalfOf">
      <path value="MedicationDispense.performer.onBehalfOf"/> 
      <short value="Organization organization was acting for"/> 
      <definition value="The organization the device or practitioner was acting on behalf of."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="….onBehalfOf"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".role.scopingOrganization"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.authorizingPrescription">
      <path value="MedicationDispense.authorizingPrescription"/> 
      <short value="Medication order that authorizes the dispense"/> 
      <definition value="Indicates the medication order that is being dispensed against."/> 
      <comment value="Maps to basedOn in Event logical model."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…basedOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ORC-2 Placer Order Number"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.type">
      <path value="MedicationDispense.type"/> 
      <short value="Trial fill, partial fill, emergency fill, etc."/> 
      <definition value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion

       of Trial, Partial Fill, Emergency Fill, Samples, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion

         of Trial, Partial Fill, Emergency Fill, Samples, etc."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-33-Dispense Type"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.quantity">
      <path value="MedicationDispense.quantity"/> 
      <short value="Amount dispensed"/> 
      <definition value="The amount of medication that has been dispensed. Includes unit of measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense

         Units.name of coding system"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".quantity"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.daysSupply">
      <path value="MedicationDispense.daysSupply"/> 
      <short value="Amount of medication expressed as a timing amount"/> 
      <definition value="The amount of medication expressed as a timing amount."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TQ1.6 Timing/Quantity Segment Service Duration.
Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component.  This

         is a formatted string, first character for the time unit (e.g., D=days), followed by the
         value.  For example, “D14” represents “14 days supply”
From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration.  This is a CQ data type
         (&lt;Quantity (NM)&gt; ^ &lt;Units (CWE)&gt;), thus for days supply, assuming the unit
         of measure is “days”, the numeric value is TQ1.6.1 (…|14^
For backwards compatibility, ORC.7 was permitted through v2.6.  Both forms (field and
         segment) may be present in v2.5, v2.5.1, and v2.6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="effectiveUseTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenPrepared">
      <path value="MedicationDispense.whenPrepared"/> 
      <short value="When product was packaged and reviewed"/> 
      <definition value="The time when the dispensed product was packaged and reviewed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].low"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/> 
      <short value="When product was given out"/> 
      <definition value="The time the dispensed product was provided to the patient or their representative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…occurrenceDateTime"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].high"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.destination">
      <path value="MedicationDispense.destination"/> 
      <short value="Where the medication was sent"/> 
      <definition value="Identification of the facility/location where the medication was shipped to, as part of

       the dispense event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy

         Address"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=DST].role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.receiver">
      <path value="MedicationDispense.receiver"/> 
      <short value="Who collected the medication"/> 
      <definition value="Identifies the person who picked up the medication.  This will usually be a patient or

       their caregiver, but some cases exist where it can be a healthcare professional."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=RCV].role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.note">
      <path value="MedicationDispense.note"/> 
      <short value="Information about the dispense"/> 
      <definition value="Extra information about the dispense that could not be conveyed in the other attributes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-9 Dispense Notes"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/> 
      <short value="How the medication is to be used by the patient or administered by the caregiver"/> 
      <definition value="Indicates how the medication is to be used by the patient."/> 
      <comment value="When the dose or rate is intended to change over the entire administration period (e.g.

       Tapering dose prescriptions), multiple instances of dosage instructions will need to be
       supplied to convey the different doses/rates.
The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction
       based on the actual product being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Dosage"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution">
      <path value="MedicationDispense.substitution"/> 
      <short value="Whether a substitution was performed on the dispense"/> 
      <definition value="Indicates whether or not substitution was made as part of the dispense.  In some cases
       substitution will be expected but does not happen, in other cases substitution is not
       expected but does happen.  This block explains what substitution did or did not happen
       and why.
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      
      
      
      
      
        
      
      
        
        
      
    
    
      
      
      May be used to represent additional information that is not part of the basic definition

       and why.  If nothing is specified, substitution was not done."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() | (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="Element"/> 
      </constraint> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.id">
      <path value="MedicationDispense.substitution.id"/> 
      <representation value="xmlAttr"/> 
      <short value="xml:id (or equivalent in JSON)"/> 
      <definition value="unique id for the element within a resource (for internal references). This may be any

       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.extension">
      <path value="MedicationDispense.substitution.extension"/> 
      <short value="Additional Content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension.
      There can be no stigma associated with the use of extensions by any application, project,

       be met as part of the definition of the extension."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone.
      
      
      
      
      
        
      
      
        
        
      
    
    
      
      
      May be used to represent additional information that is not part of the basic definition

       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.modifierExtension">
      <path value="MedicationDispense.substitution.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions.
      There can be no stigma associated with the use of extensions by any application, project,

       processing a resource are required to check for modifier extensions."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone.
      
      
      
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        A coded concept describing whether a different medicinal product may be dispensed other
         than the product as specified exactly in the prescription
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        A coded concept describing the reason that a different medication should (or should not)
         be substituted from what was prescribed
        
          
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        
      
    
  
  
    
      
      
      Indicates that a medication product is to be or has been dispensed for a named person/patient.

       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.wasSubstituted">
      <path value="MedicationDispense.substitution.wasSubstituted"/> 
      <short value="Whether a substitution was or was not performed on the dispense"/> 
      <definition value="True if the dispenser dispensed a different drug or product from what was prescribed."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".actionNegationInd"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.type">
      <path value="MedicationDispense.substitution.type"/> 
      <short value="Code signifying whether a different drug was dispensed from what was prescribed"/> 
      <definition value="A code signifying whether a different drug was dispensed from what was prescribed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept describing whether a different medicinal product may be dispensed other

         than the product as specified exactly in the prescription"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.reason">
      <path value="MedicationDispense.substitution.reason"/> 
      <short value="Why was substitution made"/> 
      <definition value="Indicates the reason for the substitution of (or lack of substitution) from what was prescribed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept describing the reason that a different medication should (or should not)

         be substituted from what was prescribed"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.responsibleParty">
      <path value="MedicationDispense.substitution.responsibleParty"/> 
      <short value="Who is responsible for the substitution"/> 
      <definition value="The person or organization that has primary responsibility for the substitution."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.detectedIssue">
      <path value="MedicationDispense.detectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or

       proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy,
       dosage alert etc."/> 
      <alias value="Contraindication"/> 
      <alias value="Drug Utilization Review (DUR)"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.notDone">
      <path value="MedicationDispense.notDone"/> 
      <short value="Whether the dispense was or was not performed"/> 
      <definition value="True if the dispense was not performed for some reason."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…notDone"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".actionNegationInd"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.notDoneReason[x]">
      <path value="MedicationDispense.notDoneReason[x]"/> 
      <short value="Why a dispense was not performed"/> 
      <definition value="Indicates the reason why a dispense was not performed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…notDoneReason"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;not

         done reason&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.eventHistory">
      <path value="MedicationDispense.eventHistory"/> 
      <short value="A list of releveant lifecycle events"/> 
      <definition value="A summary of the events of interest that have occurred, such as when the dispense was

       verified."/> 
      <comment value="This may not include provenances for all versions of the request – only those deemed “relevant”

       or important. This SHALL NOT include the Provenance associated with this current version
       of the resource. (If that provenance is deemed to be a “relevant” change, it will need
       to be added as part of a later update. Until then, it can be queried directly as the Provenance
       that points to this version using _revinclude All Provenances should have some historical
       version of this Request as their subject.)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="MedicationDispense">
      <path value="MedicationDispense"/> 
      <short value="Dispensing a medication to a named patient"/> 
      <definition value="Indicates that a medication product is to be or has been dispensed for a named person/patient.
        This includes a description of the medication product (supply) provided and the instructions
       for administering the medication.  The medication dispense is the result of a pharmacy
       system responding to a medication order.
      
      
      
        
      
      
        
        
        
        not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va
        lue &gt;= f:whenPrepared/@value)
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      Identifier assigned by the dispensing facility - this is an identifier assigned outside
       FHIR.
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
      
        
        
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
      
        
        
      
      
      
        
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        RXD-10-Dispensing Provider / PRT-5-Participation Person: PRT-4-Participation='DP' (RXD-10
         is deprecated)
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
       of Trial, Partial Fill, Emergency Fill, Samples, etc.
      
      
      
        
      
      
      
        
        Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
         of Trial, Partial Fill, Emergency Fill, Samples, etc.
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense
         Units.name of coding system
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
    
    
      
      
      Identifies the medication being administered. This is either a link to a resource representing

       system responding to a medication order."/> 
      <comment value="The WG will be updating the MedicationDispense resource  to adjust each affected resource

       to align with the workflow pattern (see workflow.html)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <constraint> 
        <key value="mdd-1"/> 
        <severity value="error"/> 
        <human value="whenHandedOver cannot be before whenPrepared"/> 
        <expression value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver &gt;= whenPrepared"/> 
        <xpath value="not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va

        lue &gt;= f:whenPrepared/@value)"/> 
      </constraint> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="..Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Supply[moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.identifier">
      <path value="MedicationDispense.identifier"/> 
      <short value="External identifier"/> 
      <definition value="Identifier assigned by the dispensing facility - this is an identifier assigned outside

       FHIR."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="id"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.partOf">
      <path value="MedicationDispense.partOf"/> 
      <short value="Event that dispense is part of"/> 
      <definition value="The procedure that the dispense is done because of."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…part of"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/> 
      <short value="preparation | in-progress | on-hold | completed | entered-in-error | stopped"/> 
      <definition value="A code specifying the state of the set of dispense events."/> 
      <comment value="This element is labeled as a modifier because the status contains codes that mark the

       resource as not currently valid."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <isModifier value="true"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="A coded concept specifying the state of the dispense event."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/medication-dispense-status"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="status"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.category">
      <path value="MedicationDispense.category"/> 
      <short value="Type of medication dispense"/> 
      <definition value="Indicates type of medication dispense and where the medication is expected to be consumed

       or administered."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="A code describing where the dispensed medication is expected to be consumed or administered"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/medication-dispense-category"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type

         of medication dispense&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/> 
      <short value="What medication was supplied"/> 
      <definition value="Identifies the medication being administered. This is either a link to a resource representing
       the details of the medication or a simple attribute carrying a code that identifies the
       medication from a known list of medications.
      If only a code is specified, then it needs to be a code for a specific product.  If more
       information is required, then the use of the medication resource is recommended.  Note:
       do not use Medication.name to describe the dispensed medication. When the only available
       information is a text description of the medication, Medication.code.text should be used.
      
      
      
        
      
      
        
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      Identification of the facility/location where the medication was shipped to, as part of
       the dispense event.
      
      
      
        
        
      
      
      
        
        RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy
         Address
      
      
        
        
      
    
    
      
      
      Identifies the person who picked up the medication.  This will usually be a patient or
       their caregiver, but some cases exist where it can be a healthcare professional.
      
      
      
        
        
      
      
        
        
      
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      
      When the dose or rate is intended to change over the entire administration period (e.g.

       medication from a known list of medications."/> 
      <comment value="If only a code is specified, then it needs to be a code for a specific product. If more

       information is required, then the use of the medication resource is recommended.  For
       example if you require form or lot number, then you must reference the Medication resource. ."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
      </type> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying which substance or product can be dispensed"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/medication-codes"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…code"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-2-Dispense/Give Code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRD].role"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="what"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.subject">
      <path value="MedicationDispense.subject"/> 
      <short value="Who the dispense is for"/> 
      <definition value="A link to a resource representing the person or the group to whom the medication will

       be given."/> 
      <comment value="SubstanceAdministration-&gt;subject-&gt;Patient."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…subject"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3-Patient ID List"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="who.focus"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.context">
      <path value="MedicationDispense.context"/> 
      <short value="Encounter / Episode associated with event"/> 
      <definition value="The encounter or episode of care that establishes the context for this event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type

         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.supportingInformation">
      <path value="MedicationDispense.supportingInformation"/> 
      <short value="Information that supports the dispensing of the medication"/> 
      <definition value="Additional information that supports the medication being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal

         with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of
         the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS,
         RQO, PRP, APT, ARQ, GOL)]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="context"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer">
      <path value="MedicationDispense.performer"/> 
      <short value="Who performed event"/> 
      <definition value="Indicates who or what performed the event.  It should be assumed that the performer is

       the dispenser of the medication."/> 
      <comment value="The performer will be reviewed as part of STU4."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…performer"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRF]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.actor">
      <path value="MedicationDispense.performer.actor"/> 
      <short value="Individual who was performing"/> 
      <definition value="The device, practitioner, etc. who performed the action.  It should be assumed that the

       actor is the dispenser of the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="….actor"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.onBehalfOf">
      <path value="MedicationDispense.performer.onBehalfOf"/> 
      <short value="Organization organization was acting for"/> 
      <definition value="The organization the device or practitioner was acting on behalf of."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="….onBehalfOf"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".role.scopingOrganization"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.authorizingPrescription">
      <path value="MedicationDispense.authorizingPrescription"/> 
      <short value="Medication order that authorizes the dispense"/> 
      <definition value="Indicates the medication order that is being dispensed against."/> 
      <comment value="Maps to basedOn in Event logical model."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…basedOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ORC-2 Placer Order Number"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.type">
      <path value="MedicationDispense.type"/> 
      <short value="Trial fill, partial fill, emergency fill, etc."/> 
      <definition value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion

       of Trial, Partial Fill, Emergency Fill, Samples, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion

         of Trial, Partial Fill, Emergency Fill, Samples, etc."/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-33-Dispense Type"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.quantity">
      <path value="MedicationDispense.quantity"/> 
      <short value="Amount dispensed"/> 
      <definition value="The amount of medication that has been dispensed. Includes unit of measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense

         Units.name of coding system"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".quantity"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.daysSupply">
      <path value="MedicationDispense.daysSupply"/> 
      <short value="Amount of medication expressed as a timing amount"/> 
      <definition value="The amount of medication expressed as a timing amount."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TQ1.6 Timing/Quantity Segment Service Duration.
Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component.  This

         is a formatted string, first character for the time unit (e.g., D=days), followed by the
         value.  For example, “D14” represents “14 days supply”
From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration.  This is a CQ data type
         (&lt;Quantity (NM)&gt; ^ &lt;Units (CWE)&gt;), thus for days supply, assuming the unit
         of measure is “days”, the numeric value is TQ1.6.1 (…|14^
For backwards compatibility, ORC.7 was permitted through v2.6.  Both forms (field and
         segment) may be present in v2.5, v2.5.1, and v2.6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="effectiveUseTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenPrepared">
      <path value="MedicationDispense.whenPrepared"/> 
      <short value="When product was packaged and reviewed"/> 
      <definition value="The time when the dispensed product was packaged and reviewed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].low"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/> 
      <short value="When product was given out"/> 
      <definition value="The time the dispensed product was provided to the patient or their representative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…occurrenceDateTime"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].high"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.destination">
      <path value="MedicationDispense.destination"/> 
      <short value="Where the medication was sent"/> 
      <definition value="Identification of the facility/location where the medication was shipped to, as part of

       the dispense event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy

         Address"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=DST].role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.receiver">
      <path value="MedicationDispense.receiver"/> 
      <short value="Who collected the medication"/> 
      <definition value="Identifies the person who picked up the medication.  This will usually be a patient or

       their caregiver, but some cases exist where it can be a healthcare professional."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=RCV].role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.note">
      <path value="MedicationDispense.note"/> 
      <short value="Information about the dispense"/> 
      <definition value="Extra information about the dispense that could not be conveyed in the other attributes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-9 Dispense Notes"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/> 
      <short value="How the medication is to be used by the patient or administered by the caregiver"/> 
      <definition value="Indicates how the medication is to be used by the patient."/> 
      <comment value="When the dose or rate is intended to change over the entire administration period (e.g.
       Tapering dose prescriptions), multiple instances of dosage instructions will need to be
       supplied to convey the different doses/rates.
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      Free text dosage instructions can be used for cases where the instructions are too complex
       to code. When coded instructions are present, the free text instructions may still be
       present for display to humans taking or administering the medication.
      
      
      
        
      
      
    
    
      
      
      Additional instructions such as &quot;Swallow with plenty of water&quot; which may or
       may not be coded.
      
      
      
        
      
      
      
        
        Codes identifying additional instructions such as &quot;take with water&quot; or &quot;avoid
         operating heavy machinery&quot;
      
      
        
        
      
    
    
      
      
      The timing schedule for giving the medication to the patient.  The Schedule data type
       allows many different expressions.  For example, &quot;Every  8 hours&quot;; &quot;Three
       times a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;;
        &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;.
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      Indicates whether the Medication is only taken when needed within a specific dosing schedule
       (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
          Specifically if 'boolean' datatype is selected, then the following logic applies: 
       If set to True, this indicates that the medication is only taken when needed, within the
       specified schedule.
      
      
      
        
      
      
        
      
      
      
        
        A coded concept identifying the precondition that should be met or evaluated prior to
         consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30
         minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc.
      
      
        
        boolean: .outboundRelationship[typeCode=PRCN].negationInd (inversed - so negationInd =
         true means asNeeded=false  CodeableConcept: .outboundRelationship[typCode=PRCN].target[classCode=OBS
        , moodCode=EVN, isCriterionInd=true, code=&quot;Assertion&quot;].value
      
    
    
      
      
      
      
      
      
        
      
      
        
        
      
      
      
        
        
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      A code specifying the route or physiological path of administration of a therapeutic agent
       into or onto a subject.
      
      
      
        
      
      
      
        
        A coded concept describing the route or physiological path of administration of a therapeutic
         agent into or onto the body of a subject
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      A coded value indicating the method by which the medication is intended to be or was introduced
       into or on the body.
      This attribute will most often NOT be populated.  It is most commonly used for injections.
        For example, Slow Push, Deep IV.  One of the reasons this attribute is not used often,
       is that the method is often pre-coordinated with the route and/or form of administration.
        This means the codes used in route or form may pre-coordinate the method in the route
       code or the form code.  The implementation decision about what coding system to use for
       route or form code will determine how frequently the method code will be populated e.g.
       if route or form code pre-coordinate method code, then this attribute will not be populated
       often; if there is no pre-coordination then method code may  be used frequently.
      
      
      
        
      
      
      
        
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      Note that this specifies the quantity of the specified medication, not the quantity of
       active ingredient(s).  The prescribed strength can be calculated by multiplying the doseQuantity
       by the strength of each active ingredient in the prescribed Medication. If the administration
       is not intended to be instantaneous (rate is present or timing has a duration), this can
       be specified to convey the total amount to be administered over the period of time as
       indicated by the schedule.
      
      
      
        
      
      
        
        
      
      
      
        
        RXE-23-Give Rate Amount / RXE-24.1-Give Rate Units.code / RXE-24.3-Give Rate Units.name
         of coding system
      
      
        
        
      
    
    
      
      
      Identifies the speed with which the medication was or will be introduced into the patient.
       Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed
       as a rate per unit of time e.g. 500 ml per 2 hours.   Currently we do not specify a default
       of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or
       200 mcg/1 minute; 1 liter/8 hours.
      
      
      
        
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      The maximum total quantity of a therapeutic substance that may be administered to a subject
       over the period of time,  e.g. 1000mg in 24 hours.
      
      
      
        
      
      
      
        
        
      
      
        
        
      
    
    
      
      
      Indicates whether or not substitution was made as part of the dispense.  In some cases

       supplied to convey the different doses/rates.
The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction
       based on the actual product being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Dosage"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution">
      <path value="MedicationDispense.substitution"/> 
      <short value="Whether a substitution was performed on the dispense"/> 
      <definition value="Indicates whether or not substitution was made as part of the dispense.  In some cases
       substitution will be expected but does not happen, in other cases substitution is not
       expected but does happen.  This block explains what substitution did or did not happen
       and why.
      
      
      
        
      
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        A coded concept describing whether a different medicinal product may be dispensed other
         than the product as specified exactly in the prescription
        
          
        
      
      
        
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
      
      
      
        
        A coded concept describing the reason that a different medication should (or should not)
         be substituted from what was prescribed
        
          
        
      
      
        
        
      
    
    
      
      
      
      
      
      
        
        
      
      
      
        
        
      
    
  

       and why.  If nothing is specified, substitution was not done."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.wasSubstituted">
      <path value="MedicationDispense.substitution.wasSubstituted"/> 
      <short value="Whether a substitution was or was not performed on the dispense"/> 
      <definition value="True if the dispenser dispensed a different drug or product from what was prescribed."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".actionNegationInd"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.type">
      <path value="MedicationDispense.substitution.type"/> 
      <short value="Code signifying whether a different drug was dispensed from what was prescribed"/> 
      <definition value="A code signifying whether a different drug was dispensed from what was prescribed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept describing whether a different medicinal product may be dispensed other

         than the product as specified exactly in the prescription"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.reason">
      <path value="MedicationDispense.substitution.reason"/> 
      <short value="Why was substitution made"/> 
      <definition value="Indicates the reason for the substitution of (or lack of substitution) from what was prescribed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept describing the reason that a different medication should (or should not)

         be substituted from what was prescribed"/> 
        <valueSetReference> 
          <reference value="http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"/> 
        </valueSetReference> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.responsibleParty">
      <path value="MedicationDispense.substitution.responsibleParty"/> 
      <short value="Who is responsible for the substitution"/> 
      <definition value="The person or organization that has primary responsibility for the substitution."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.detectedIssue">
      <path value="MedicationDispense.detectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or

       proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy,
       dosage alert etc."/> 
      <alias value="Contraindication"/> 
      <alias value="Drug Utilization Review (DUR)"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.notDone">
      <path value="MedicationDispense.notDone"/> 
      <short value="Whether the dispense was or was not performed"/> 
      <definition value="True if the dispense was not performed for some reason."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…notDone"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".actionNegationInd"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.notDoneReason[x]">
      <path value="MedicationDispense.notDoneReason[x]"/> 
      <short value="Why a dispense was not performed"/> 
      <definition value="Indicates the reason why a dispense was not performed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="…notDoneReason"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;not

         done reason&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.eventHistory">
      <path value="MedicationDispense.eventHistory"/> 
      <short value="A list of releveant lifecycle events"/> 
      <definition value="A summary of the events of interest that have occurred, such as when the dispense was

       verified."/> 
      <comment value="This may not include provenances for all versions of the request – only those deemed “relevant”

       or important. This SHALL NOT include the Provenance associated with this current version
       of the resource. (If that provenance is deemed to be a “relevant” change, it will need
       to be added as part of a later update. Until then, it can be queried directly as the Provenance
       that points to this version using _revinclude All Provenances should have some historical
       version of this Request as their subject.)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/> 
      </type> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </differential> 


</

StructureDefinition

>