2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## : MedicationDispense negation example - XML Representation

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    <MedicationDispense xmlns="http://hl7.org/fhir">
      <id value="negation-example"/>
      <meta>
        <profile
                 value="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationdispensedeclined"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: MedicationDispense negation-example</b></p><a name="negation-example"> </a><a name="hcnegation-example"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-us-quality-core-medicationdispensedeclined.html">US Quality Core MedicationDispense Declined</a></p></div><p><b>US Quality Core Not Done Recorded</b>: 2017-01-17</p><p><b>status</b>: Declined</p><p><b>statusReason</b>: <span title="Codes:{http://snomed.info/sct 183966005}">Drug treatment not indicated (situation)</span></p><p><b>medication</b>: <span title="Codes:">Not Done Value Set: Ophthalmic Antihistamines</span> (Not done value set: <a href="https://vsac.nlm.nih.gov/valueset/1.3.6.1.4.1.6997.4.1.2.268.13.35211.1.13.1.999.321/expansion">Ophthalmic Antihistamines</a>)</p><p><b>subject</b>: <a href="Patient-example.html">Jim Chalmers  Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>authorizingPrescription</b>: <a href="MedicationRequest-example.html">MedicationRequest: status = active; intent = order; medication[x] = -&gt;Medication alemtuzumab 10 MG/ML [Lemtrada]; authoredOn = 2015-03-25 19:32:52-0500; reasonCode = Multiple sclerosis (disorder)</a></p><blockquote><p><b>dosageInstruction</b></p><p><b>timing</b>: 3 per 1 day</p><p><b>route</b>: <span title="Codes:{http://snomed.info/sct 394899003}">oral administration of treatment</span></p><h3>DoseAndRates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Dose[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/dose-rate-type ordered}">Ordered</span></td><td>5 ml<span style="background: LightGoldenRodYellow"> (Details: UCUM  codeml = 'ml')</span></td></tr></table></blockquote></div>
      </text>
      <extension
                 url="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded">
        <valueDateTime value="2017-01-17"/>
      </extension>
      <status value="declined"/>
      <statusReasonCodeableConcept>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="183966005"/>
          <display value="Drug treatment not indicated (situation)"/>
        </coding>
      </statusReasonCodeableConcept>
      <medicationCodeableConcept>
        <extension
                   url="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet">
          <valueCanonical
                          value="http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.6997.4.1.2.268.13.35211.1.13.1.999.321"/>
        </extension>
        <text value="Not Done Value Set: Ophthalmic Antihistamines"/>
      </medicationCodeableConcept>
      <subject>🔗
        <reference value="Patient/example"/>
      </subject>
      <authorizingPrescription>🔗
        <reference value="MedicationRequest/example"/>
      </authorizingPrescription>
      <dosageInstruction>
        <timing>
          <repeat>
            <frequency value="3"/>
            <period value="1"/>
            <periodUnit value="d"/>
          </repeat>
        </timing>
        <route>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="394899003"/>
            <display value="oral administration of treatment"/>
          </coding>
        </route>
        <doseAndRate>
          <type>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
              <code value="ordered"/>
              <display value="Ordered"/>
            </coding>
          </type>
          <doseQuantity>
            <value value="5"/>
            <unit value="ml"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="ml"/>
          </doseQuantity>
        </doseAndRate>
      </dosageInstruction>
    </MedicationDispense>