{
  "resourceType": "MedicationStatement",
  "id": "example001",
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0309",
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/sid/ndc",
            "code": "50580-608-02",
            "display": "Tylenol PM Extra Strength, 1 BOTTLE in 1 CARTON (50580-608-02) \u003e 100 TABLET, FILM COATED in 1 BOTTLE (package)"
          }
        ],
        "text": "Tylenol PM"
      },
      "doseForm": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "385057009",
            "display": "Film-coated tablet (basic dose form)"
          }
        ]
      },
      "ingredient": [
        {
          "item": {
            "concept": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "code": "315266",
                  "display": "Acetaminophen 500 MG"
                }
              ]
            }
          },
          "strengthRatio": {
            "numerator": {
              "value": 500,
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            },
            "denominator": {
              "value": 1,
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "TAB"
            }
          }
        },
        {
          "item": {
            "concept": {
              "coding": [
                {
                  "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                  "code": "901813",
                  "display": "Diphenhydramine Hydrochloride 25 mg"
                }
              ]
            }
          },
          "strengthRatio": {
            "numerator": {
              "value": 25,
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            },
            "denominator": {
              "value": 1,
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "TAB"
            }
          }
        }
      ]
    }
  ],
  "identifier": [
    {
      "use": "official",
      "system": "http://www.bmc.nl/portal/medstatements",
      "value": "12345689"
    }
  ],
  "status": "recorded",
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/medication-statement-category",
          "code": "inpatient",
          "display": "Inpatient"
        }
      ]
    }
  ],
  "medication": {
    "reference": {
      "reference": "#med0309"
    }
  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "effectiveDateTime": "2015-01-23",
  "dateAsserted": "2015-02-22",
  "informationSource": [
    {
      "reference": "Patient/pat1",
      "display": "Donald Duck"
    }
  ],
  "derivedFrom": [
    {
      "reference": "MedicationRequest/medrx002"
    }
  ],
  "reason": [
    {
      "concept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "32914008",
            "display": "Restless Legs"
          }
        ]
      }
    }
  ],
  "note": [
    {
      "text": "Patient indicates they miss the occasional dose"
    }
  ],
  "meta": {
    "tag": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code": "HTEST",
        "display": "test health data"
      }
    ]
  }
}