<!--  This is an example of a medication being refused by a patient  -->
  <!--  This example illustrates hhow such documentation may represent an exclusion criterion for a quality measure  -->
  <!--  This example uses a QRDA tempalte to document reason with a coded concept  -->
<section xmlns="urn:hl7-org:v3">
  <templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
  <templateId root="2.16.840.1.113883.10.20.22.2.1.1" extension="2014-06-09"/>
  <!--  Medication Section (entries required)  -->
  <code displayName="History of Medication Use" codeSystemName="LOINC"
        codeSystem="2.16.840.1.113883.6.1" code="10160-0"/>
  <title>MEDICATIONS</title>
  <text>
    <table width="100%" border="1">
      <thead>
        <tr>
          <th>Medication</th>
          <th>Dosage</th>
          <th>Effective Dates (start - stop)</th>
          <th>Comments</th>
        </tr>
      </thead>
      <tbody>
        <tr ID="Medication_0">
          <td>Patient refused:
            
            <content ID="MedicationName_0">Lisinopril 10mg Oral Tablet</content>
          </td>
          <td>NA</td>
          <td>March 15, 2018</td>
          <td ID="Medication_0_comment">Patient refused</td>
        </tr>
      </tbody>
    </table>
  </text>
  <entry typeCode="DRIV">
    <!--  Since the negation has occurred, the moodCode is set to "EVN" with negationInd to "true"  -->
    <substanceAdministration negationInd="true" moodCode="EVN"
                             classCode="SBADM">
      <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
      <templateId root="2.16.840.1.113883.10.20.22.4.16"
                  extension="2014-06-09"/>
      <id root="47d3e719-f688-459d-bcdc-47c6de0767b9"/>
      <text>
        <!--  This reference refers to medication information in unstructured portion of section -->
        <reference value="#Medication_0"/>
      </text>
      <statusCode code="completed"/>
      <!--  This effectiveTime is a point in time  -->
      <effectiveTime xsi:type="SXCM-TS" value="20180315112305-0500"/>
      <routeCode nullFlavor="NA"/>
      <doseQuantity nullFlavor="NA"/>
      <consumable>
        <manufacturedProduct classCode="MANU">
          <!--  ** Medication information **  -->
          <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
          <templateId root="2.16.840.1.113883.10.20.22.4.23"
                      extension="2014-06-09"/>
          <id root="2a620155-9d11-439e-92b3-5d9815ff4eb8"/>
          <manufacturedMaterial>
            <!--  Medications should be specified at a level corresponding to prescription when possible, such as 600mg oral tablet (non-branded) -->
            <code displayName="lisinopril 10 MG Oral Tablet"
                  codeSystemName="RxNorm" codeSystem="2.16.840.1.113883.6.88" code="314076">
              <originalText>
                <reference value="#MedicationName_0"/>
              </originalText>
            </code>
          </manufacturedMaterial>
        </manufacturedProduct>
      </consumable>
      <author>
        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
        <!--  Time the author noted that patient is on no medications  -->
        <time value="20180315112305-0500"/>
        <assignedAuthor>
          <id root="2.16.840.1.113883.4.6" extension="66666"/>
          <code
                displayName="Allopathic &amp; Osteopathic Physicians; Internal Medicine, Cardiovascular Disease" codeSystemName="NUCC" codeSystem="2.16.840.1.113883.6.101"
                code="207RC0000X"/>
          <addr>
            <streetAddressLine>6666 StreetName St.</streetAddressLine>
            <city>Silver Spring</city>
            <state>MD</state>
            <postalCode>20901</postalCode>
            <country>US</country>
          </addr>
          <telecom value="tel:+1(301)666-6666" use="WP"/>
          <assignedPerson>
            <name>
              <given>Heartly</given>
              <family>Sixer</family>
              <suffix>MD</suffix>
            </name>
          </assignedPerson>
        </assignedAuthor>
      </author>
      <!--  Comment activity  -->
      <entryRelationship typeCode="COMP">
        <act moodCode="EVN" classCode="ACT">
          <templateId root="2.16.840.1.113883.10.20.22.4.64"/>
          <code displayName="Annotation Comment" codeSystemName="LOINC"
                codeSystem="2.16.840.1.113883.6.1" code="48767-8"/>
          <text>
            <reference value="#Medication_0_comment"/>
          </text>
        </act>
      </entryRelationship>
      <!--  This is the QRDA template  -->
      <entryRelationship typeCode="COMP">
        <observation moodCode="EVN" classCode="OBS">
          <!--  Reason (V2)  -->
          <templateId root="2.16.840.1.113883.10.20.24.3.88"
                      extension="2014-12-01"/>
          <templateId root="2.16.840.1.113883.10.20.24.3.88"
                      extension="2023-05-01"/>
          <!--  Companion Guide  -->
          <id root="5750a5bb-6a01-4b99-9b1c-cda56b1dce0c"/>
          <code xsi:type="CD"
                displayName="Reason care action performed or not" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1"
                code="77301-0"/>
          <statusCode code="completed"/>
          <effectiveTime>
            <low value="20180315112305-0500"/>
          </effectiveTime>
          <!--  sdtc:valueset extension is required in many QRDA templates. It's allowed in C-CDA.  -->
          <value xsi:type="CD" xmlns:sdtc="urn:hl7-org:sdtc"
                 sdtcvalueSet="2.16.840.1.113883.3.526.3.1008" displayName="Procedure declined by patient"
                 codeSystemName="SNOMED CT" codeSystem="2.16.840.1.113883.6.96" code="105480006"/>
        </observation>
      </entryRelationship>
    </substanceAdministration>
  </entry>
</section>