Important elements in this profile:

• MedicationDispense.subject
  • A reference to the patient receiving the medication SHALL be populated
• MedicationDispense.medicationCodeableConcept (or Medication reference)
  • The dispensed medication SHALL be populated, including the associated RxNorm code and NDC11 reflecting the medication name, strength and dose form
  • For information concerning mapping between NDC and RxNorm, see Mapping NDC, RXCUI, and Drug Names in the RxNorm Files
• MedicationDispense.performer
  • The party that dispensed the medication SHALL be populated using either a reference to the performer (PDMP Organization-Pharmacy or US Core Practitioner resource) or an identifier specifying both the identifier value and system
• MedicationDispense.authorizingPrescription
  • A reference to the authorizing MedicationRequest SHOULD be populated
• MedicationDispense.quantity
  • Quantity, including numeric value and units SHALL be populated
  • When the dispense quantity is stated in terms of “eaches” (e.g., tablets, capsules, etc.), populate only the quantity.unit value with the text “each”. Do not populate the quantity.system or quantity.code values
• MedicationDispense.daysSupply
  • Dispensed days supply SHALL be populated
• MedicationDispense.whenPrepared
  • The date that the medication was prepared SHALL be populated in the whenPrepared element
• MedicationDispense.medicationCodeableConcept.userSelected
  • The userSelected element associated with the drug code received from the pharmacy or other dispensation data source
  • The userSelected element associated with any additional drug codes provided SHALL NOT be populated
• MedicationDispense.authorizingPrescription.identifier
  • This element SHOULD be populated with the authorizing prescription’s pharmacy-assigned prescription number, if known; otherwise it should be populated with the authorizing prescription’s prescriber-system-assigned order number, if known

Technical note:

A rule defined in the base MedicationDispense StructureDefinition causes an error to be produced when a valid date is present in MedicationDispense.whenPrepared and a Data Absent Reason extension is used in place of MedicationDispense.whenHandedOver. This rule (invariant mdd-1), which asserts that the whenPrepared date must precede the whenHandedOver date, interprets whenHandedOver’s value as ‘null’ in this situation, causing the test to fail. A request has been submitted to adjust the rule to accommodate this valid use of the Data Absent Reason extension in a future FHIR release.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USCoreMedicationDispenseProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
rx-fill-number	S	0..1	positiveInt	PDMP Extension - Prescription Fill Number URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number
rx-transmission-method	S	0..1	Coding	PDMP Extension - Prescription Transmission Method URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method Binding: PDMP Value Set - Prescription Transmission Method (extensible)
rx-mme	S	0..1	decimal	PDMP Extension - MME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme
rx-lme	S	0..1	decimal	PDMP Extension - LME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme
rx-method-of-payment		0..1	Coding	PDMP Extension - Method of Payment URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment Binding: PDMP Value Set - Method of Payment (extensible)
rx-opioid-treatment-code		0..1	Coding	PDMP Extension - Opioid Treatment Code URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code Binding: PDMP Value Set - Opioid Treatment Code (required)
identifier		0..*	Identifier	External identifier
value		0..1	string	The value that is unique
status		1..1	code	(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A set of codes indicating the current status of a MedicationDispense.
Slices for medication[x]		1..1	CodeableConcept, Reference(US Core Medication Profile)	(USCDI) What medication was supplied Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible): Prescribable medications
medication[x]:medicationCodeableConcept		0..1	CodeableConcept	(USCDI) What medication was supplied
coding
system		0..1	uri	Identity of the terminology system
code		0..1	code	Symbol in syntax defined by the system
userSelected	S	0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
performer		1..1	BackboneElement	(USCDI) Who performed event
actor	C	1..1	Reference(US Core Practitioner Profile | PDMP Organization - Pharmacy)	(USCDI) Individual who was performing pdmp-dispense-performer: MedicationDispense SHALL include a performer actor reference or performer actor identifier
reference	S	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	S	0..1	Identifier	Logical reference, when literal reference is not known
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
display	S	0..1	string	Text alternative for the resource
authorizingPrescription		0..1	Reference(US Core MedicationRequest Profile)	(USCDI) Medication order that authorizes the dispense
identifier	S	0..1	Identifier	Logical reference, when literal reference is not known
type		0..1	CodeableConcept	(USCDI) Trial fill, partial fill, emergency fill, etc.
quantity		1..1	Quantity	(USCDI) Amount dispensed
value	S	1..1	decimal	Numerical value (with implicit precision)
unit	S	1..1	string	Unit representation
system	S	0..1	uri	System that defines coded unit form
code	S	0..1	code	Coded form of the unit
daysSupply	S	1..1	SimpleQuantity	Amount of medication expressed as a timing amount
value	S	1..1	decimal	Numerical value (with implicit precision)
whenPrepared	S	1..1	dateTime	When product was packaged and reviewed
note		0..*	Annotation	Information about the dispense
dosageInstruction		0..1	Dosage	(USCDI) How the medication is to be used by the patient or administered by the caregiver
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
pdmp-dispense-performer	error	MedicationDispense.performer.actor	MedicationDispense SHALL include a performer actor reference or performer actor identifier : reference.exists() or identifier.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
rx-fill-number	S	0..1	positiveInt	PDMP Extension - Prescription Fill Number URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number
rx-transmission-method	S	0..1	Coding	PDMP Extension - Prescription Transmission Method URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method Binding: PDMP Value Set - Prescription Transmission Method (extensible)
rx-mme	S	0..1	decimal	PDMP Extension - MME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme
rx-lme	S	0..1	decimal	PDMP Extension - LME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme
rx-method-of-payment		0..1	Coding	PDMP Extension - Method of Payment URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment Binding: PDMP Value Set - Method of Payment (extensible)
rx-opioid-treatment-code		0..1	Coding	PDMP Extension - Opioid Treatment Code URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code Binding: PDMP Value Set - Opioid Treatment Code (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value	Σ	0..1	string	The value that is unique Example General: 123456
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A set of codes indicating the current status of a MedicationDispense.
Slices for medication[x]	SΣ	1..1		(USCDI) What medication was supplied Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
medication[x]:medicationCodeableConcept	SΣ	0..1	CodeableConcept	(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	0..1	uri	Identity of the terminology system
code	Σ	0..1	code	Symbol in syntax defined by the system
userSelected	SΣ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the dispense is for
performer	S	1..1	BackboneElement	(USCDI) Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	SC	1..1	Reference(US Core Practitioner Profile)	(USCDI) Individual who was performing pdmp-dispense-performer: MedicationDispense SHALL include a performer actor reference or performer actor identifier
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
display	SΣ	0..1	string	Text alternative for the resource
authorizingPrescription	S	0..1	Reference(US Core MedicationRequest Profile)	(USCDI) Medication order that authorizes the dispense
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
type	S	0..1	CodeableConcept	(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	1..1	Quantity	(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	0..1	uri	System that defines coded unit form
code	SΣ	0..1	code	Coded form of the unit
daysSupply	S	1..1	SimpleQuantity	Amount of medication expressed as a timing amount
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
whenPrepared	SΣ	1..1	dateTime	When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(USCDI) When product was given out or mailed
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..1	Dosage	(USCDI) How the medication is to be used by the patient or administered by the caregiver
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.performer.actor.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.quantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
pdmp-dispense-performer	error	MedicationDispense.performer.actor	MedicationDispense SHALL include a performer actor reference or performer actor identifier : reference.exists() or identifier.exists()
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
rx-fill-number	S	0..1	positiveInt	PDMP Extension - Prescription Fill Number URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number
rx-transmission-method	S	0..1	Coding	PDMP Extension - Prescription Transmission Method URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method Binding: PDMP Value Set - Prescription Transmission Method (extensible)
rx-mme	S	0..1	decimal	PDMP Extension - MME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme
rx-lme	S	0..1	decimal	PDMP Extension - LME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme
rx-method-of-payment		0..1	Coding	PDMP Extension - Method of Payment URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment Binding: PDMP Value Set - Method of Payment (extensible)
rx-opioid-treatment-code		0..1	Coding	PDMP Extension - Opioid Treatment Code URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code Binding: PDMP Value Set - Opioid Treatment Code (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
partOf		0..*	Reference(Procedure)	Event that dispense is part of
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A set of codes indicating the current status of a MedicationDispense.
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x]	SΣ	1..1		(USCDI) What medication was supplied Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
medication[x]:medicationCodeableConcept	SΣ	0..1	CodeableConcept	(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	SΣ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the dispense is for
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	S	1..1	BackboneElement	(USCDI) Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor	SC	1..1	Reference(US Core Practitioner Profile S | PDMP Organization - Pharmacy)	(USCDI) Individual who was performing pdmp-dispense-performer: MedicationDispense SHALL include a performer actor reference or performer actor identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	SΣ	0..1	string	Text alternative for the resource
location		0..1	Reference(Location)	Where the dispense occurred
authorizingPrescription	S	0..1	Reference(US Core MedicationRequest Profile)	(USCDI) Medication order that authorizes the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
type	S	0..1	CodeableConcept	(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	1..1	Quantity	(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	0..1	uri	System that defines coded unit form
code	SΣ	0..1	code	Coded form of the unit
daysSupply	S	1..1	SimpleQuantity	Amount of medication expressed as a timing amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
whenPrepared	SΣ	1..1	dateTime	When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(USCDI) When product was given out or mailed
destination		0..1	Reference(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..1	Dosage	(USCDI) How the medication is to be used by the patient or administered by the caregiver
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
substitution		0..1	BackboneElement	Whether a substitution was performed on the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted		1..1	boolean	Whether a substitution was or was not performed on the dispense
type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.performer.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.performer.actor.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.performer.actor.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationDispense.authorizingPrescription.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.quantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
MedicationDispense.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationDispense.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationDispense.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationDispense.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
pdmp-dispense-performer	error	MedicationDispense.performer.actor	MedicationDispense SHALL include a performer actor reference or performer actor identifier : reference.exists() or identifier.exists()
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

Differential View

This structure is derived from USCoreMedicationDispenseProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
rx-fill-number	S	0..1	positiveInt	PDMP Extension - Prescription Fill Number URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number
rx-transmission-method	S	0..1	Coding	PDMP Extension - Prescription Transmission Method URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method Binding: PDMP Value Set - Prescription Transmission Method (extensible)
rx-mme	S	0..1	decimal	PDMP Extension - MME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme
rx-lme	S	0..1	decimal	PDMP Extension - LME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme
rx-method-of-payment		0..1	Coding	PDMP Extension - Method of Payment URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment Binding: PDMP Value Set - Method of Payment (extensible)
rx-opioid-treatment-code		0..1	Coding	PDMP Extension - Opioid Treatment Code URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code Binding: PDMP Value Set - Opioid Treatment Code (required)
identifier		0..*	Identifier	External identifier
value		0..1	string	The value that is unique
status		1..1	code	(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A set of codes indicating the current status of a MedicationDispense.
Slices for medication[x]		1..1	CodeableConcept, Reference(US Core Medication Profile)	(USCDI) What medication was supplied Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible): Prescribable medications
medication[x]:medicationCodeableConcept		0..1	CodeableConcept	(USCDI) What medication was supplied
coding
system		0..1	uri	Identity of the terminology system
code		0..1	code	Symbol in syntax defined by the system
userSelected	S	0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
performer		1..1	BackboneElement	(USCDI) Who performed event
actor	C	1..1	Reference(US Core Practitioner Profile | PDMP Organization - Pharmacy)	(USCDI) Individual who was performing pdmp-dispense-performer: MedicationDispense SHALL include a performer actor reference or performer actor identifier
reference	S	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	S	0..1	Identifier	Logical reference, when literal reference is not known
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
display	S	0..1	string	Text alternative for the resource
authorizingPrescription		0..1	Reference(US Core MedicationRequest Profile)	(USCDI) Medication order that authorizes the dispense
identifier	S	0..1	Identifier	Logical reference, when literal reference is not known
type		0..1	CodeableConcept	(USCDI) Trial fill, partial fill, emergency fill, etc.
quantity		1..1	Quantity	(USCDI) Amount dispensed
value	S	1..1	decimal	Numerical value (with implicit precision)
unit	S	1..1	string	Unit representation
system	S	0..1	uri	System that defines coded unit form
code	S	0..1	code	Coded form of the unit
daysSupply	S	1..1	SimpleQuantity	Amount of medication expressed as a timing amount
value	S	1..1	decimal	Numerical value (with implicit precision)
whenPrepared	S	1..1	dateTime	When product was packaged and reviewed
note		0..*	Annotation	Information about the dispense
dosageInstruction		0..1	Dosage	(USCDI) How the medication is to be used by the patient or administered by the caregiver
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
pdmp-dispense-performer	error	MedicationDispense.performer.actor	MedicationDispense SHALL include a performer actor reference or performer actor identifier : reference.exists() or identifier.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
rx-fill-number	S	0..1	positiveInt	PDMP Extension - Prescription Fill Number URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number
rx-transmission-method	S	0..1	Coding	PDMP Extension - Prescription Transmission Method URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method Binding: PDMP Value Set - Prescription Transmission Method (extensible)
rx-mme	S	0..1	decimal	PDMP Extension - MME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme
rx-lme	S	0..1	decimal	PDMP Extension - LME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme
rx-method-of-payment		0..1	Coding	PDMP Extension - Method of Payment URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment Binding: PDMP Value Set - Method of Payment (extensible)
rx-opioid-treatment-code		0..1	Coding	PDMP Extension - Opioid Treatment Code URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code Binding: PDMP Value Set - Opioid Treatment Code (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value	Σ	0..1	string	The value that is unique Example General: 123456
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A set of codes indicating the current status of a MedicationDispense.
Slices for medication[x]	SΣ	1..1		(USCDI) What medication was supplied Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
medication[x]:medicationCodeableConcept	SΣ	0..1	CodeableConcept	(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	0..1	uri	Identity of the terminology system
code	Σ	0..1	code	Symbol in syntax defined by the system
userSelected	SΣ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the dispense is for
performer	S	1..1	BackboneElement	(USCDI) Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	SC	1..1	Reference(US Core Practitioner Profile)	(USCDI) Individual who was performing pdmp-dispense-performer: MedicationDispense SHALL include a performer actor reference or performer actor identifier
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
display	SΣ	0..1	string	Text alternative for the resource
authorizingPrescription	S	0..1	Reference(US Core MedicationRequest Profile)	(USCDI) Medication order that authorizes the dispense
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
type	S	0..1	CodeableConcept	(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	1..1	Quantity	(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	0..1	uri	System that defines coded unit form
code	SΣ	0..1	code	Coded form of the unit
daysSupply	S	1..1	SimpleQuantity	Amount of medication expressed as a timing amount
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
whenPrepared	SΣ	1..1	dateTime	When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(USCDI) When product was given out or mailed
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..1	Dosage	(USCDI) How the medication is to be used by the patient or administered by the caregiver
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.performer.actor.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.quantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
pdmp-dispense-performer	error	MedicationDispense.performer.actor	MedicationDispense SHALL include a performer actor reference or performer actor identifier : reference.exists() or identifier.exists()
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
rx-fill-number	S	0..1	positiveInt	PDMP Extension - Prescription Fill Number URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number
rx-transmission-method	S	0..1	Coding	PDMP Extension - Prescription Transmission Method URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method Binding: PDMP Value Set - Prescription Transmission Method (extensible)
rx-mme	S	0..1	decimal	PDMP Extension - MME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme
rx-lme	S	0..1	decimal	PDMP Extension - LME URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme
rx-method-of-payment		0..1	Coding	PDMP Extension - Method of Payment URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment Binding: PDMP Value Set - Method of Payment (extensible)
rx-opioid-treatment-code		0..1	Coding	PDMP Extension - Opioid Treatment Code URL: http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code Binding: PDMP Value Set - Opioid Treatment Code (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
partOf		0..*	Reference(Procedure)	Event that dispense is part of
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A set of codes indicating the current status of a MedicationDispense.
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x]	SΣ	1..1		(USCDI) What medication was supplied Slice: Unordered, Open by type:$this Binding: Medication Clinical Drug (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
medication[x]:medicationCodeableConcept	SΣ	0..1	CodeableConcept	(USCDI) What medication was supplied Binding: Medication Clinical Drug (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	SΣ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the dispense is for
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	S	1..1	BackboneElement	(USCDI) Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor	SC	1..1	Reference(US Core Practitioner Profile S | PDMP Organization - Pharmacy)	(USCDI) Individual who was performing pdmp-dispense-performer: MedicationDispense SHALL include a performer actor reference or performer actor identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	SΣ	0..1	string	Text alternative for the resource
location		0..1	Reference(Location)	Where the dispense occurred
authorizingPrescription	S	0..1	Reference(US Core MedicationRequest Profile)	(USCDI) Medication order that authorizes the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
type	S	0..1	CodeableConcept	(USCDI) Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (extensible)
quantity	S	1..1	Quantity	(USCDI) Amount dispensed Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	0..1	uri	System that defines coded unit form
code	SΣ	0..1	code	Coded form of the unit
daysSupply	S	1..1	SimpleQuantity	Amount of medication expressed as a timing amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
whenPrepared	SΣ	1..1	dateTime	When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(USCDI) When product was given out or mailed
destination		0..1	Reference(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note		0..*	Annotation	Information about the dispense
dosageInstruction	S	0..1	Dosage	(USCDI) How the medication is to be used by the patient or administered by the caregiver
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
substitution		0..1	BackboneElement	Whether a substitution was performed on the dispense
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted		1..1	boolean	Whether a substitution was or was not performed on the dispense
type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.performer.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.performer.actor.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.performer.actor.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationDispense.authorizingPrescription.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.type	extensible	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.quantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
MedicationDispense.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationDispense.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationDispense.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationDispense.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
pdmp-dispense-performer	error	MedicationDispense.performer.actor	MedicationDispense SHALL include a performer actor reference or performer actor identifier : reference.exists() or identifier.exists()
us-core-20	error	MedicationDispense	whenHandedOver SHALL be present if the status is "completed" : status='completed' implies whenHandedOver.exists()

This structure is derived from USCoreMedicationDispenseProfile

Summary

Mandatory: 7 elements(2 nested mandatory elements)
Must-Support: 18 elements

Structures

This structure refers to these other structures:

• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• PDMP Organization - Pharmacy (http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-organization-pharmacy)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number
• http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method
• http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme
• http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme
• http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment
• http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationDispense.medication[x]