<MedicationStatement xmlns="http://hl7.org/fhir"><id value="example001"/><contained><Medication><id value="med0309"/><code><coding><system value="http://hl7.org/fhir/sid/ndc"/><code value="50580-608-02"/><display value="Tylenol PM Extra Strength, 1 BOTTLE in 1 CARTON (50580-608-02) &gt; 100 TABLET, FILM COATED in 1 BOTTLE (package)"/></coding><text value="Tylenol PM"/></code><doseForm><coding><system value="http://snomed.info/sct"/><code value="385057009"/><display value="Film-coated tablet (basic dose form)"/></coding></doseForm><ingredient><item><concept><coding><system value="http://www.nlm.nih.gov/research/umls/rxnorm"/><code value="315266"/><display value="Acetaminophen 500 MG"/></coding></concept></item><strengthRatio><numerator><value value="500"/><system value="http://unitsofmeasure.org"/><code value="mg"/></numerator><denominator><value value="1"/><system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/><code value="TAB"/></denominator></strengthRatio></ingredient><ingredient><item><concept><coding><system value="http://www.nlm.nih.gov/research/umls/rxnorm"/><code value="901813"/><display value="Diphenhydramine Hydrochloride 25 mg"/></coding></concept></item><strengthRatio><numerator><value value="25"/><system value="http://unitsofmeasure.org"/><code value="mg"/></numerator><denominator><value value="1"/><system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/><code value="TAB"/></denominator></strengthRatio></ingredient></Medication></contained><identifier><use value="official"/><system value="http://www.bmc.nl/portal/medstatements"/><value value="12345689"/></identifier><status value="recorded"/><category><coding><system value="http://terminology.hl7.org/CodeSystem/medication-statement-category"/><code value="inpatient"/><display value="Inpatient"/></coding></category><medication><reference><reference value="#med0309"/></reference></medication><subject><reference value="Patient/pat1"/><display value="Donald Duck"/></subject><effectiveDateTime value="2015-01-23"/><dateAsserted value="2015-02-22"/><informationSource><reference value="Patient/pat1"/><display value="Donald Duck"/></informationSource><derivedFrom><reference value="MedicationRequest/medrx002"/></derivedFrom><reason><concept><coding><system value="http://snomed.info/sct"/><code value="32914008"/><display value="Restless Legs"/></coding></concept></reason><note><text value="Patient indicates they miss the occasional dose"/></note><dosage/></MedicationStatement>