Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON

Logical Model: Medication Activity

A Medication Activity describes substance administrations that have actually occurred (e.g., pills ingested or injections given) or are intended to occur (e.g., “take 2 tablets twice a day for the next 10 days”). Medication activities in “INT” mood are reflections of what a clinician intends a patient to be taking. For example, a clinician may intend that a patient be administered Lisinopril 20 mg PO for blood pressure control. If what was actually administered was Lisinopril 10 mg., then the Medication activities in the “EVN” mood would reflect actual use.

A moodCode of INT is allowed, but it is recommended that the Planned Medication Activity template be used for moodCodes other than EVN if the document type contains a section that includes Planned Medication Activity (for example a Care Plan document with Plan of Treatment, Intervention, or Goal sections).

At a minimum, a Medication Activity shall include an effectiveTime indicating the duration of the administration (or single-administration timestamp). Ambulatory medication lists generally provide a summary of use for a given medication over time - a medication activity in event mood with the duration reflecting when the medication started and stopped. Ongoing medications will not have a stop date (or will have a stop date with a suitable NULL value). Ambulatory medication lists will generally also have a frequency (e.g., a medication is being taken twice a day). Inpatient medications generally record each administration as a separate act.

The dose (doseQuantity) represents how many of the consumables are to be administered at each administration event. As a result, the dose is always relative to the consumable and the interval of administration. Thus, a patient consuming a single “metoprolol 25mg tablet” per administration will have a doseQuantity of “1”, whereas a patient consuming “metoprolol Oral Product” (RxCUI 1163523) will have a dose of “25 mg”.

Usage:

• Use this Logical Model: Admission Medication, Anesthesia Section, Discharge Medication, Intervention Act... Show 5 more, Medications Administered Section, Medications Section, Planned Intervention Act, Procedure Activity Procedure and Reaction Observation

Formal Views of Template Content

Description of Template, Differentials, Snapshots and how the different presentations work.

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

This structure is derived from SubstanceAdministration

Name	Flags	Card.	Type	Description & Constraints
SubstanceAdministration	C	1..1	SubstanceAdministration	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:medication-activity		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.16
@extension		1..1	st	Required Pattern: 2014-06-09
@classCode		1..1	cs
@moodCode		1..1	cs	Binding: MoodCodeEvnInt (required)
id		1..*	II
code		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set.
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@code		1..1	cs	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: Medication Status (required)
Slices for effectiveTime		1..*	SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS	Slice: Unordered, Open by type:$this
effectiveTime:duration	C	1..1	IVL_TS	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there **SHALL** be an effectiveTime documentation of the duration (or single-administration timestamp), and that there **SHOULD** be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Note: This effectiveTime represents either the time the medication was started and stopped or the single-administration timestamp. 1098-32890: This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). should-value-att: SHOULD contain @value should-low: SHOULD contain low
@value		0..1	ts	indicates a single-administration timestamp
low		0..1	IVXB_TS	indicates when medication started
high		0..1	IVXB_TS	indicates when medication stopped
effectiveTime:periodicFrequency		0..1	EIVL_TS	This effectiveTime represents a periodic medication frequency (e.g., administration times per day).
@operator		1..1	cs	Required Pattern: A
effectiveTime:eventFrequency		0..1	PIVL_TS	This effectiveTime represents an event-based medication frequency (e.g., administration at bedtime).
@operator		1..1	cs	Required Pattern: A
repeatNumber		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
routeCode	C	0..1	CE	Binding: SPL Drug Route of Administration Terminology (required) should-translation: SHOULD contain translation
translation		0..*	CD	Binding: Medication Route (preferred)
approachSiteCode		0..1	CD	Binding: Body Site Value Set (required)
doseQuantity	C	1..1	IVL_PQ	If the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878). should-unit: SHOULD contain @unit
@unit		0..1	cs	(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (preferred)
rateQuantity		0..1	IVL_PQ
@unit		1..1	cs	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (required)
maxDoseQuantity		0..1	RTO_PQ_PQ
administrationUnitCode		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: AdministrationUnitDoseForm (required)
consumable		1..1	InfrastructureRoot	(USCDI) Medications
manufacturedProduct		1..1	MedicationInformation	Base for all types and resources
performer		0..1	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:drugVehicle		0..*	Participant2
@typeCode		1..1	cs	Fixed Value: CSM
participantRole		1..1	DrugVehicle	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
entryRelationship:indication		0..*	EntryRelationship	(USCDI) Indication
@typeCode		1..1	cs	Fixed Value: RSON
observation		1..1	Indication	Base for all types and resources
entryRelationship:instruction		0..1	EntryRelationship
@typeCode		1..1	cs	Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act		1..1	Instruction	Base for all types and resources
entryRelationship:supplyOrder		0..1	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
supply		1..1	MedicationSupplyOrder	Base for all types and resources
entryRelationship:medicationDispense		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
supply		1..1	MedicationDispense	Base for all types and resources
entryRelationship:reaction		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: CAUS
observation		1..1	ReactionObservation	Base for all types and resources
entryRelationship:drugMonitoring		0..1	EntryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
act		1..1	DrugMonitoringAct	Base for all types and resources
entryRelationship:substanceAdministered		0..*	EntryRelationship	The following entryRelationship is used to indicate a given medication's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
@typeCode		1..1	cs	Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
sequenceNumber		0..1	INT
act		1..1	SubstanceAdministeredAct	Base for all types and resources
entryRelationship:adherence		0..*	EntryRelationship	(USCDI) Medication Adherence
@typeCode		1..1	cs	Fixed Value: COMP
observation		1..1	MedicationAdherence	Base for all types and resources
entryRelationship:signature		0..*	EntryRelationship	(USCDI) Medication Instructions
@typeCode		1..1	cs	Fixed Value: COMP
substanceAdministration		1..1	MedicationFreeTextSig	Base for all types and resources
precondition		0..*	Precondition
@typeCode		1..1	cs
criterion		1..1	PreconditionforSubstanceAdministration	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
SubstanceAdministration.moodCode	required	MoodCodeEvnInt http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.18 from https://vsac.nlm.nih.gov
SubstanceAdministration.statusCode.code	required	MedicationStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.11 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode	required	SPLDrugRouteOfAdministrationTerminology http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.7 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode.translation	preferred	MedicationRoute http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.12 from https://vsac.nlm.nih.gov
SubstanceAdministration.approachSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.unit	preferred	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.rateQuantity.unit	required	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.administrationUnitCode	required	AdministrationUnitDoseForm http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.30 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	SubstanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
1098-32890	error	SubstanceAdministration.effectiveTime:duration	This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). : (value.exists() or low.exists()) and ((value.exists() and low.exists()).not())
dose-unit-or-admin-unit	error	SubstanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
should-author	warning	SubstanceAdministration	SHOULD contain author : author.exists()
should-low	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain low : low.exists()
should-routeCode	warning	SubstanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-text-ref-value	warning	SubstanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-translation	warning	SubstanceAdministration.routeCode	SHOULD contain translation : translation.exists()
should-unit	warning	SubstanceAdministration.doseQuantity	SHOULD contain @unit : nullFlavor.exists() or unit.exists()
should-value-att	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain @value : value.exists()
value-starts-octothorpe	error	SubstanceAdministration.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
SubstanceAdministration	C	1..1	SubstanceAdministration	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:medication-activity		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.16
@extension		1..1	st	Required Pattern: 2014-06-09
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: SBADM
@moodCode		1..1	cs	Binding: MoodCodeEvnInt (required)
id		1..*	II
code		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set. Binding: CDAActSubstanceAdministrationCode (example)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: Medication Status (required)
Slices for effectiveTime		1..*		Slice: Unordered, Open by type:$this
effectiveTime			SXCM_TS
effectiveTime			IVL_TS
effectiveTime			EIVL_TS
effectiveTime			PIVL_TS
effectiveTime			SXPR_TS
effectiveTime:duration	C	1..1	IVL_TS	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there **SHALL** be an effectiveTime documentation of the duration (or single-administration timestamp), and that there **SHOULD** be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Note: This effectiveTime represents either the time the medication was started and stopped or the single-administration timestamp. 1098-32890: This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). should-value-att: SHOULD contain @value should-low: SHOULD contain low
@value		0..1	ts	indicates a single-administration timestamp Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
low		0..1	IVXB_TS	indicates when medication started
high		0..1	IVXB_TS	indicates when medication stopped
effectiveTime:periodicFrequency		0..1	EIVL_TS	This effectiveTime represents a periodic medication frequency (e.g., administration times per day).
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
effectiveTime:eventFrequency		0..1	PIVL_TS	This effectiveTime represents an event-based medication frequency (e.g., administration at bedtime).
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
repeatNumber		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
routeCode	C	0..1	CE	Binding: SPL Drug Route of Administration Terminology (required) should-translation: SHOULD contain translation
translation		0..*	CD	Binding: Medication Route (preferred)
approachSiteCode		0..1	CD	Binding: Body Site Value Set (required)
doseQuantity	C	1..1	IVL_PQ	If the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878). should-unit: SHOULD contain @unit
@unit		0..1	cs	(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (preferred)
rateQuantity		0..1	IVL_PQ
@unit		1..1	cs	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (required)
maxDoseQuantity		0..1	RTO_PQ_PQ
administrationUnitCode		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: AdministrationUnitDoseForm (required)
consumable		1..1	InfrastructureRoot	(USCDI) Medications
manufacturedProduct	C	1..1	MedicationInformation	Base for all types and resources product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
performer		0..1	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:drugVehicle		0..*	Participant2
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: CSM
participantRole	C	1..1	DrugVehicle	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
entryRelationship:indication		0..*	EntryRelationship	(USCDI) Indication
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
entryRelationship:instruction		0..1	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:supplyOrder		0..1	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
supply	C	1..1	MedicationSupplyOrder	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:medicationDispense		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
supply	C	1..1	MedicationDispense	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:reaction		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: CAUS
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
entryRelationship:drugMonitoring		0..1	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
act	C	1..1	DrugMonitoringAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:substanceAdministered		0..*	EntryRelationship	The following entryRelationship is used to indicate a given medication's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
sequenceNumber		0..1	INT
act	C	1..1	SubstanceAdministeredAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:adherence		0..*	EntryRelationship	(USCDI) Medication Adherence
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
observation	C	1..1	MedicationAdherence	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-informant: SHOULD contain informant
entryRelationship:signature		0..*	EntryRelationship	(USCDI) Medication Instructions
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
substanceAdministration	C	1..1	MedicationFreeTextSig	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
precondition		0..*	Precondition
@typeCode		1..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: PRCN
criterion		1..1	PreconditionforSubstanceAdministration	Base for all types and resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
SubstanceAdministration.classCode	required	Fixed Value: SBADM http://hl7.org/cda/stds/core/ValueSet/CDAActClass
SubstanceAdministration.moodCode	required	MoodCodeEvnInt http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.18 from https://vsac.nlm.nih.gov
SubstanceAdministration.code	example	CDAActSubstanceAdministrationCode http://hl7.org/cda/stds/core/ValueSet/CDAActSubstanceAdministrationCode
SubstanceAdministration.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
SubstanceAdministration.statusCode.code	required	MedicationStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.11 from https://vsac.nlm.nih.gov
SubstanceAdministration.effectiveTime:periodicFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.effectiveTime:eventFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.routeCode	required	SPLDrugRouteOfAdministrationTerminology http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.7 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode.translation	preferred	MedicationRoute http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.12 from https://vsac.nlm.nih.gov
SubstanceAdministration.approachSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.unit	preferred	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.rateQuantity.unit	required	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.administrationUnitCode	required	AdministrationUnitDoseForm http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.30 from https://vsac.nlm.nih.gov
SubstanceAdministration.participant:drugVehicle.typeCode	required	Fixed Value: CSM http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
SubstanceAdministration.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:supplyOrder.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:medicationDispense.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:reaction.typeCode	required	Fixed Value: CAUS http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:drugMonitoring.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:substanceAdministered.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:adherence.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:signature.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.precondition.typeCode	required	Fixed Value: PRCN http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	SubstanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
1098-32890	error	SubstanceAdministration.effectiveTime:duration	This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). : (value.exists() or low.exists()) and ((value.exists() and low.exists()).not())
dose-unit-or-admin-unit	error	SubstanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	SubstanceAdministration.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
product-choice	error	SubstanceAdministration.consumable.manufacturedProduct	manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present) : (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choice	error	SubstanceAdministration.participant:drugVehicle.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
should-author	warning	SubstanceAdministration	SHOULD contain author : author.exists()
should-effectiveTime	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	SubstanceAdministration.entryRelationship:adherence.observation	SHOULD contain informant : informant.exists()
should-low	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain low : low.exists()
should-quantity	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain quantity : quantity.exists()
should-repeatNumber	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain repeatNumber : repeatNumber.exists()
should-routeCode	warning	SubstanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-text-ref-value	warning	SubstanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation, SubstanceAdministration.entryRelationship:drugMonitoring.act, SubstanceAdministration.entryRelationship:substanceAdministered.act, SubstanceAdministration.entryRelationship:adherence.observation, SubstanceAdministration.entryRelationship:signature.substanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-translation	warning	SubstanceAdministration.routeCode	SHOULD contain translation : translation.exists()
should-unit	warning	SubstanceAdministration.doseQuantity	SHOULD contain @unit : nullFlavor.exists() or unit.exists()
should-value-att	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain @value : value.exists()
value-starts-octothorpe	error	SubstanceAdministration.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
SubstanceAdministration	C	1..1	SubstanceAdministration	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:medication-activity		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.16
@extension		1..1	st	Required Pattern: 2014-06-09
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: SBADM
@moodCode		1..1	cs	Binding: MoodCodeEvnInt (required)
id		1..*	II
code		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set. Binding: CDAActSubstanceAdministrationCode (example)
@negationInd		0..1	bl
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: Medication Status (required)
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
Slices for effectiveTime		1..*		Slice: Unordered, Open by type:$this
effectiveTime			SXCM_TS
effectiveTime			IVL_TS
effectiveTime			EIVL_TS
effectiveTime			PIVL_TS
effectiveTime			SXPR_TS
effectiveTime:duration	C	1..1	IVL_TS	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there **SHALL** be an effectiveTime documentation of the duration (or single-administration timestamp), and that there **SHOULD** be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Note: This effectiveTime represents either the time the medication was started and stopped or the single-administration timestamp. 1098-32890: This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). should-value-att: SHOULD contain @value should-low: SHOULD contain low
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	indicates a single-administration timestamp Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_TS	indicates when medication started
center		0..1	TS
width		0..1	PQ
high		0..1	IVXB_TS	indicates when medication stopped
effectiveTime:periodicFrequency		0..1	EIVL_TS	This effectiveTime represents a periodic medication frequency (e.g., administration times per day).
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
event		0..1	CE
offset		0..1	IVL_PQ
effectiveTime:eventFrequency		0..1	PIVL_TS	This effectiveTime represents an event-based medication frequency (e.g., administration at bedtime).
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
phase		0..1	IVL_TS
period		0..1	PQ
@alignment		0..1	cs
@institutionSpecified		0..1	bl
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
routeCode	C	0..1	CE	Binding: SPL Drug Route of Administration Terminology (required) should-translation: SHOULD contain translation
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		0..1	cs
@codeSystem		0..1	oid, uuid, ruid
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
translation		0..*	CD	Binding: Medication Route (preferred)
approachSiteCode		0..1	CD	Binding: Body Site Value Set (required)
doseQuantity	C	1..1	IVL_PQ	If the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878). should-unit: SHOULD contain @unit
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@unit		0..1	cs	(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (preferred)
@value		0..1	real
translation		0..*	PQR
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_PQ
center		0..1	PQ
width		0..1	PQ
high		0..1	IVXB_PQ
rateQuantity		0..1	IVL_PQ
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@unit		1..1	cs	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (required)
@value		0..1	real
translation		0..*	PQR
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_PQ
center		0..1	PQ
width		0..1	PQ
high		0..1	IVXB_PQ
maxDoseQuantity		0..1	RTO_PQ_PQ
administrationUnitCode		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: AdministrationUnitDoseForm (required)
consumable		1..1	InfrastructureRoot	(USCDI) Medications
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: CDAParticipationType (required) Fixed Value: CSM
manufacturedProduct	C	1..1	MedicationInformation	Base for all types and resources product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..1	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:drugVehicle		0..*	Participant2
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: CSM
@contextControlCode		0..1	cs	Binding: CDAContextControl (required) Fixed Value: OP
sdtcFunctionCode		0..1	CE	XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc)
time		0..1	IVL_TS
awarenessCode		0..1	CE
participantRole	C	1..1	DrugVehicle	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
entryRelationship:indication		0..*	EntryRelationship	(USCDI) Indication
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:instruction		0..1	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:supplyOrder		0..1	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply	C	1..1	MedicationSupplyOrder	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:medicationDispense		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply	C	1..1	MedicationDispense	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:reaction		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: CAUS
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:drugMonitoring		0..1	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	DrugMonitoringAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:substanceAdministered		0..*	EntryRelationship	The following entryRelationship is used to indicate a given medication's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	SubstanceAdministeredAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:adherence		0..*	EntryRelationship	(USCDI) Medication Adherence
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	MedicationAdherence	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-informant: SHOULD contain informant
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:signature		0..*	EntryRelationship	(USCDI) Medication Instructions
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	MedicationFreeTextSig	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
supply		0..1	Supply
reference		0..*	Reference
precondition		0..*	Precondition
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: PRCN
criterion		1..1	PreconditionforSubstanceAdministration	Base for all types and resources
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
SubstanceAdministration.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.templateId:medication-activity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.classCode	required	Fixed Value: SBADM http://hl7.org/cda/stds/core/ValueSet/CDAActClass
SubstanceAdministration.moodCode	required	MoodCodeEvnInt http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.18 from https://vsac.nlm.nih.gov
SubstanceAdministration.code	example	CDAActSubstanceAdministrationCode http://hl7.org/cda/stds/core/ValueSet/CDAActSubstanceAdministrationCode
SubstanceAdministration.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
SubstanceAdministration.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
SubstanceAdministration.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
SubstanceAdministration.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
SubstanceAdministration.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
SubstanceAdministration.statusCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.statusCode.code	required	MedicationStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.11 from https://vsac.nlm.nih.gov
SubstanceAdministration.effectiveTime:duration.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.effectiveTime:duration.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.effectiveTime:periodicFrequency.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.effectiveTime:periodicFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.effectiveTime:eventFrequency.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.effectiveTime:eventFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
SubstanceAdministration.routeCode	required	SPLDrugRouteOfAdministrationTerminology http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.7 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.routeCode.translation	preferred	MedicationRoute http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.12 from https://vsac.nlm.nih.gov
SubstanceAdministration.approachSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.doseQuantity.unit	preferred	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.rateQuantity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.rateQuantity.unit	required	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.rateQuantity.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.administrationUnitCode	required	AdministrationUnitDoseForm http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.30 from https://vsac.nlm.nih.gov
SubstanceAdministration.consumable.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.consumable.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.consumable.typeCode	required	Fixed Value: CSM http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
SubstanceAdministration.participant:drugVehicle.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeCode	required	Fixed Value: CSM http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
SubstanceAdministration.participant:drugVehicle.contextControlCode	required	Fixed Value: OP http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
SubstanceAdministration.entryRelationship:indication.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:instruction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:supplyOrder.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:supplyOrder.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:supplyOrder.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:medicationDispense.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:medicationDispense.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:medicationDispense.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:reaction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:reaction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:reaction.typeCode	required	Fixed Value: CAUS http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:drugMonitoring.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:drugMonitoring.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:drugMonitoring.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:substanceAdministered.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdministered.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdministered.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:adherence.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:adherence.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:adherence.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:signature.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:signature.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:signature.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.precondition.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.precondition.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.precondition.typeCode	required	Fixed Value: PRCN http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	SubstanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
1098-32890	error	SubstanceAdministration.effectiveTime:duration	This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). : (value.exists() or low.exists()) and ((value.exists() and low.exists()).not())
dose-unit-or-admin-unit	error	SubstanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	SubstanceAdministration.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
product-choice	error	SubstanceAdministration.consumable.manufacturedProduct	manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present) : (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choice	error	SubstanceAdministration.participant:drugVehicle.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
should-author	warning	SubstanceAdministration	SHOULD contain author : author.exists()
should-effectiveTime	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	SubstanceAdministration.entryRelationship:adherence.observation	SHOULD contain informant : informant.exists()
should-low	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain low : low.exists()
should-quantity	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain quantity : quantity.exists()
should-repeatNumber	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain repeatNumber : repeatNumber.exists()
should-routeCode	warning	SubstanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-text-ref-value	warning	SubstanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation, SubstanceAdministration.entryRelationship:drugMonitoring.act, SubstanceAdministration.entryRelationship:substanceAdministered.act, SubstanceAdministration.entryRelationship:adherence.observation, SubstanceAdministration.entryRelationship:signature.substanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-translation	warning	SubstanceAdministration.routeCode	SHOULD contain translation : translation.exists()
should-unit	warning	SubstanceAdministration.doseQuantity	SHOULD contain @unit : nullFlavor.exists() or unit.exists()
should-value-att	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain @value : value.exists()
value-starts-octothorpe	error	SubstanceAdministration.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from SubstanceAdministration

Summary

Mandatory: 10 elements(15 nested mandatory elements)
Fixed: 12 elements

Structures

This structure refers to these other structures:

• Medication Information (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationInformation)
• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)
• Drug Vehicle (http://hl7.org/cda/us/ccda/StructureDefinition/DrugVehicle)
• Indication (http://hl7.org/cda/us/ccda/StructureDefinition/Indication)
• Instruction (http://hl7.org/cda/us/ccda/StructureDefinition/Instruction)
• Medication Supply Order (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationSupplyOrder)
• Medication Dispense (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationDispense)
• Reaction Observation (http://hl7.org/cda/us/ccda/StructureDefinition/ReactionObservation)
• Drug Monitoring Act (http://hl7.org/cda/us/ccda/StructureDefinition/DrugMonitoringAct)
• Substance Administered Act (http://hl7.org/cda/us/ccda/StructureDefinition/SubstanceAdministeredAct)
• Medication Adherence (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationAdherence)
• Medication Free Text Sig (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationFreeTextSig)
• Precondition for Substance Administration (http://hl7.org/cda/us/ccda/StructureDefinition/PreconditionforSubstanceAdministration)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of SubstanceAdministration.templateId
• The element 1 is sliced based on the value of SubstanceAdministration.effectiveTime
• The element 1 is sliced based on the value of SubstanceAdministration.participant
• The element 4 is sliced based on the values of SubstanceAdministration.entryRelationship

Differential View

This structure is derived from SubstanceAdministration

Name	Flags	Card.	Type	Description & Constraints
SubstanceAdministration	C	1..1	SubstanceAdministration	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:medication-activity		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.16
@extension		1..1	st	Required Pattern: 2014-06-09
@classCode		1..1	cs
@moodCode		1..1	cs	Binding: MoodCodeEvnInt (required)
id		1..*	II
code		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set.
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@code		1..1	cs	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: Medication Status (required)
Slices for effectiveTime		1..*	SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS	Slice: Unordered, Open by type:$this
effectiveTime:duration	C	1..1	IVL_TS	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there **SHALL** be an effectiveTime documentation of the duration (or single-administration timestamp), and that there **SHOULD** be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Note: This effectiveTime represents either the time the medication was started and stopped or the single-administration timestamp. 1098-32890: This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). should-value-att: SHOULD contain @value should-low: SHOULD contain low
@value		0..1	ts	indicates a single-administration timestamp
low		0..1	IVXB_TS	indicates when medication started
high		0..1	IVXB_TS	indicates when medication stopped
effectiveTime:periodicFrequency		0..1	EIVL_TS	This effectiveTime represents a periodic medication frequency (e.g., administration times per day).
@operator		1..1	cs	Required Pattern: A
effectiveTime:eventFrequency		0..1	PIVL_TS	This effectiveTime represents an event-based medication frequency (e.g., administration at bedtime).
@operator		1..1	cs	Required Pattern: A
repeatNumber		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
routeCode	C	0..1	CE	Binding: SPL Drug Route of Administration Terminology (required) should-translation: SHOULD contain translation
translation		0..*	CD	Binding: Medication Route (preferred)
approachSiteCode		0..1	CD	Binding: Body Site Value Set (required)
doseQuantity	C	1..1	IVL_PQ	If the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878). should-unit: SHOULD contain @unit
@unit		0..1	cs	(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (preferred)
rateQuantity		0..1	IVL_PQ
@unit		1..1	cs	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (required)
maxDoseQuantity		0..1	RTO_PQ_PQ
administrationUnitCode		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: AdministrationUnitDoseForm (required)
consumable		1..1	InfrastructureRoot	(USCDI) Medications
manufacturedProduct		1..1	MedicationInformation	Base for all types and resources
performer		0..1	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:drugVehicle		0..*	Participant2
@typeCode		1..1	cs	Fixed Value: CSM
participantRole		1..1	DrugVehicle	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
entryRelationship:indication		0..*	EntryRelationship	(USCDI) Indication
@typeCode		1..1	cs	Fixed Value: RSON
observation		1..1	Indication	Base for all types and resources
entryRelationship:instruction		0..1	EntryRelationship
@typeCode		1..1	cs	Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act		1..1	Instruction	Base for all types and resources
entryRelationship:supplyOrder		0..1	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
supply		1..1	MedicationSupplyOrder	Base for all types and resources
entryRelationship:medicationDispense		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
supply		1..1	MedicationDispense	Base for all types and resources
entryRelationship:reaction		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: CAUS
observation		1..1	ReactionObservation	Base for all types and resources
entryRelationship:drugMonitoring		0..1	EntryRelationship
@typeCode		1..1	cs	Fixed Value: COMP
act		1..1	DrugMonitoringAct	Base for all types and resources
entryRelationship:substanceAdministered		0..*	EntryRelationship	The following entryRelationship is used to indicate a given medication's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
@typeCode		1..1	cs	Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
sequenceNumber		0..1	INT
act		1..1	SubstanceAdministeredAct	Base for all types and resources
entryRelationship:adherence		0..*	EntryRelationship	(USCDI) Medication Adherence
@typeCode		1..1	cs	Fixed Value: COMP
observation		1..1	MedicationAdherence	Base for all types and resources
entryRelationship:signature		0..*	EntryRelationship	(USCDI) Medication Instructions
@typeCode		1..1	cs	Fixed Value: COMP
substanceAdministration		1..1	MedicationFreeTextSig	Base for all types and resources
precondition		0..*	Precondition
@typeCode		1..1	cs
criterion		1..1	PreconditionforSubstanceAdministration	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
SubstanceAdministration.moodCode	required	MoodCodeEvnInt http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.18 from https://vsac.nlm.nih.gov
SubstanceAdministration.statusCode.code	required	MedicationStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.11 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode	required	SPLDrugRouteOfAdministrationTerminology http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.7 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode.translation	preferred	MedicationRoute http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.12 from https://vsac.nlm.nih.gov
SubstanceAdministration.approachSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.unit	preferred	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.rateQuantity.unit	required	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.administrationUnitCode	required	AdministrationUnitDoseForm http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.30 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	SubstanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
1098-32890	error	SubstanceAdministration.effectiveTime:duration	This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). : (value.exists() or low.exists()) and ((value.exists() and low.exists()).not())
dose-unit-or-admin-unit	error	SubstanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
should-author	warning	SubstanceAdministration	SHOULD contain author : author.exists()
should-low	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain low : low.exists()
should-routeCode	warning	SubstanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-text-ref-value	warning	SubstanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-translation	warning	SubstanceAdministration.routeCode	SHOULD contain translation : translation.exists()
should-unit	warning	SubstanceAdministration.doseQuantity	SHOULD contain @unit : nullFlavor.exists() or unit.exists()
should-value-att	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain @value : value.exists()
value-starts-octothorpe	error	SubstanceAdministration.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
SubstanceAdministration	C	1..1	SubstanceAdministration	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:medication-activity		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.16
@extension		1..1	st	Required Pattern: 2014-06-09
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: SBADM
@moodCode		1..1	cs	Binding: MoodCodeEvnInt (required)
id		1..*	II
code		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set. Binding: CDAActSubstanceAdministrationCode (example)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: Medication Status (required)
Slices for effectiveTime		1..*		Slice: Unordered, Open by type:$this
effectiveTime			SXCM_TS
effectiveTime			IVL_TS
effectiveTime			EIVL_TS
effectiveTime			PIVL_TS
effectiveTime			SXPR_TS
effectiveTime:duration	C	1..1	IVL_TS	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there **SHALL** be an effectiveTime documentation of the duration (or single-administration timestamp), and that there **SHOULD** be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Note: This effectiveTime represents either the time the medication was started and stopped or the single-administration timestamp. 1098-32890: This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). should-value-att: SHOULD contain @value should-low: SHOULD contain low
@value		0..1	ts	indicates a single-administration timestamp Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
low		0..1	IVXB_TS	indicates when medication started
high		0..1	IVXB_TS	indicates when medication stopped
effectiveTime:periodicFrequency		0..1	EIVL_TS	This effectiveTime represents a periodic medication frequency (e.g., administration times per day).
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
effectiveTime:eventFrequency		0..1	PIVL_TS	This effectiveTime represents an event-based medication frequency (e.g., administration at bedtime).
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
repeatNumber		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
routeCode	C	0..1	CE	Binding: SPL Drug Route of Administration Terminology (required) should-translation: SHOULD contain translation
translation		0..*	CD	Binding: Medication Route (preferred)
approachSiteCode		0..1	CD	Binding: Body Site Value Set (required)
doseQuantity	C	1..1	IVL_PQ	If the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878). should-unit: SHOULD contain @unit
@unit		0..1	cs	(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (preferred)
rateQuantity		0..1	IVL_PQ
@unit		1..1	cs	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (required)
maxDoseQuantity		0..1	RTO_PQ_PQ
administrationUnitCode		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: AdministrationUnitDoseForm (required)
consumable		1..1	InfrastructureRoot	(USCDI) Medications
manufacturedProduct	C	1..1	MedicationInformation	Base for all types and resources product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
performer		0..1	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:drugVehicle		0..*	Participant2
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: CSM
participantRole	C	1..1	DrugVehicle	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
entryRelationship:indication		0..*	EntryRelationship	(USCDI) Indication
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
entryRelationship:instruction		0..1	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:supplyOrder		0..1	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
supply	C	1..1	MedicationSupplyOrder	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:medicationDispense		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
supply	C	1..1	MedicationDispense	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:reaction		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: CAUS
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
entryRelationship:drugMonitoring		0..1	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
act	C	1..1	DrugMonitoringAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:substanceAdministered		0..*	EntryRelationship	The following entryRelationship is used to indicate a given medication's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
sequenceNumber		0..1	INT
act	C	1..1	SubstanceAdministeredAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:adherence		0..*	EntryRelationship	(USCDI) Medication Adherence
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
observation	C	1..1	MedicationAdherence	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-informant: SHOULD contain informant
entryRelationship:signature		0..*	EntryRelationship	(USCDI) Medication Instructions
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
substanceAdministration	C	1..1	MedicationFreeTextSig	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
precondition		0..*	Precondition
@typeCode		1..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: PRCN
criterion		1..1	PreconditionforSubstanceAdministration	Base for all types and resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
SubstanceAdministration.classCode	required	Fixed Value: SBADM http://hl7.org/cda/stds/core/ValueSet/CDAActClass
SubstanceAdministration.moodCode	required	MoodCodeEvnInt http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.18 from https://vsac.nlm.nih.gov
SubstanceAdministration.code	example	CDAActSubstanceAdministrationCode http://hl7.org/cda/stds/core/ValueSet/CDAActSubstanceAdministrationCode
SubstanceAdministration.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
SubstanceAdministration.statusCode.code	required	MedicationStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.11 from https://vsac.nlm.nih.gov
SubstanceAdministration.effectiveTime:periodicFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.effectiveTime:eventFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.routeCode	required	SPLDrugRouteOfAdministrationTerminology http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.7 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode.translation	preferred	MedicationRoute http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.12 from https://vsac.nlm.nih.gov
SubstanceAdministration.approachSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.unit	preferred	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.rateQuantity.unit	required	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.administrationUnitCode	required	AdministrationUnitDoseForm http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.30 from https://vsac.nlm.nih.gov
SubstanceAdministration.participant:drugVehicle.typeCode	required	Fixed Value: CSM http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
SubstanceAdministration.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:supplyOrder.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:medicationDispense.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:reaction.typeCode	required	Fixed Value: CAUS http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:drugMonitoring.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:substanceAdministered.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:adherence.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:signature.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.precondition.typeCode	required	Fixed Value: PRCN http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	SubstanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
1098-32890	error	SubstanceAdministration.effectiveTime:duration	This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). : (value.exists() or low.exists()) and ((value.exists() and low.exists()).not())
dose-unit-or-admin-unit	error	SubstanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	SubstanceAdministration.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
product-choice	error	SubstanceAdministration.consumable.manufacturedProduct	manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present) : (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choice	error	SubstanceAdministration.participant:drugVehicle.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
should-author	warning	SubstanceAdministration	SHOULD contain author : author.exists()
should-effectiveTime	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	SubstanceAdministration.entryRelationship:adherence.observation	SHOULD contain informant : informant.exists()
should-low	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain low : low.exists()
should-quantity	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain quantity : quantity.exists()
should-repeatNumber	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain repeatNumber : repeatNumber.exists()
should-routeCode	warning	SubstanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-text-ref-value	warning	SubstanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation, SubstanceAdministration.entryRelationship:drugMonitoring.act, SubstanceAdministration.entryRelationship:substanceAdministered.act, SubstanceAdministration.entryRelationship:adherence.observation, SubstanceAdministration.entryRelationship:signature.substanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-translation	warning	SubstanceAdministration.routeCode	SHOULD contain translation : translation.exists()
should-unit	warning	SubstanceAdministration.doseQuantity	SHOULD contain @unit : nullFlavor.exists() or unit.exists()
should-value-att	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain @value : value.exists()
value-starts-octothorpe	error	SubstanceAdministration.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
SubstanceAdministration	C	1..1	SubstanceAdministration	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:medication-activity		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.16
@extension		1..1	st	Required Pattern: 2014-06-09
@classCode		1..1	cs	Binding: CDAActClass (required) Fixed Value: SBADM
@moodCode		1..1	cs	Binding: MoodCodeEvnInt (required)
id		1..*	II
code		0..1	CD	SubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used, and there is no defined value set. Binding: CDAActSubstanceAdministrationCode (example)
@negationInd		0..1	bl
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there SHALL be an effectiveTime documentation of the duration (or single-administration timestamp), and that there SHOULD be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Binding: Medication Status (required)
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
Slices for effectiveTime		1..*		Slice: Unordered, Open by type:$this
effectiveTime			SXCM_TS
effectiveTime			IVL_TS
effectiveTime			EIVL_TS
effectiveTime			PIVL_TS
effectiveTime			SXPR_TS
effectiveTime:duration	C	1..1	IVL_TS	The substance administration effectiveTime field can repeat, in order to represent varying levels of complex dosing. effectiveTime can be used to represent the duration of administration (e.g., "10 days"), the frequency of administration (e.g., "every 8 hours"), and more. Here, we require that there **SHALL** be an effectiveTime documentation of the duration (or single-administration timestamp), and that there **SHOULD** be an effectiveTime documentation of the frequency. Other timing nuances, supported by the base CDA R2 standard, may also be included. Note: This effectiveTime represents either the time the medication was started and stopped or the single-administration timestamp. 1098-32890: This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). should-value-att: SHOULD contain @value should-low: SHOULD contain low
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@value		0..1	ts	indicates a single-administration timestamp Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_TS	indicates when medication started
center		0..1	TS
width		0..1	PQ
high		0..1	IVXB_TS	indicates when medication stopped
effectiveTime:periodicFrequency		0..1	EIVL_TS	This effectiveTime represents a periodic medication frequency (e.g., administration times per day).
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
event		0..1	CE
offset		0..1	IVL_PQ
effectiveTime:eventFrequency		0..1	PIVL_TS	This effectiveTime represents an event-based medication frequency (e.g., administration at bedtime).
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@operator		1..1	cs	Binding: CDASetOperator (required) Required Pattern: A
phase		0..1	IVL_TS
period		0..1	PQ
@alignment		0..1	cs
@institutionSpecified		0..1	bl
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT	In "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
routeCode	C	0..1	CE	Binding: SPL Drug Route of Administration Terminology (required) should-translation: SHOULD contain translation
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		0..1	cs
@codeSystem		0..1	oid, uuid, ruid
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
translation		0..*	CD	Binding: Medication Route (preferred)
approachSiteCode		0..1	CD	Binding: Body Site Value Set (required)
doseQuantity	C	1..1	IVL_PQ	If the consumable code is not pre-coordinated (e.g., is "simply metoprolol Oral Product" (RxCUI 1163523), then doseQuantity must represent a physical quantity with @unit, e.g., "25" and "mg", specifying the amount of product given per administration (CONF:1098-16879).
If the consumable code is a pre-coordinated unit dose (e.g., "metoprolol 25mg tablet") then doseQuantity is a unitless number that indicates the number of products given per administration (e.g., "2", meaning 2 x "metoprolol 25mg tablet" per administration) (CONF:1098-16878). should-unit: SHOULD contain @unit
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@unit		0..1	cs	(USCDI) Dose Unit of Measure. NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (preferred)
@value		0..1	real
translation		0..*	PQR
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_PQ
center		0..1	PQ
width		0..1	PQ
high		0..1	IVXB_PQ
rateQuantity		0..1	IVL_PQ
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@unit		1..1	cs	NOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units Binding: UnitsOfMeasureCaseSensitive (required)
@value		0..1	real
translation		0..*	PQR
@operator		0..1	cs	Binding: CDASetOperator (required)
low		0..1	IVXB_PQ
center		0..1	PQ
width		0..1	PQ
high		0..1	IVXB_PQ
maxDoseQuantity		0..1	RTO_PQ_PQ
administrationUnitCode		0..1	CE	administrationUnitCode@code describes the units of medication administration for an item using a code that is pre-coordinated to include a physical unit form (ointment, powder, solution, etc.) which differs from the units used in administering the consumable (capful, spray, drop, etc.). For example when recording medication administrations, 'metric drop (C48491)'' would be appropriate to accompany the RxNorm code of 198283 (Timolol 0.25% Ophthalmic Solution) where the number of drops would be specified in doseQuantity@value. Binding: AdministrationUnitDoseForm (required)
consumable		1..1	InfrastructureRoot	(USCDI) Medications
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: CDAParticipationType (required) Fixed Value: CSM
manufacturedProduct	C	1..1	MedicationInformation	Base for all types and resources product-choice: manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..1	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
Slices for participant		0..*	Participant2	Slice: Unordered, Open by value:typeCode
participant:drugVehicle		0..*	Participant2
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: CDAParticipationType (required) Fixed Value: CSM
@contextControlCode		0..1	cs	Binding: CDAContextControl (required) Fixed Value: OP
sdtcFunctionCode		0..1	CE	XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc)
time		0..1	IVL_TS
awarenessCode		0..1	CE
participantRole	C	1..1	DrugVehicle	Base for all types and resources role-choice: playingDevice and playingEntity are mutually exclusive
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:substanceAdministration, profile:observation, profile:act, profile:supply
entryRelationship:indication		0..*	EntryRelationship	(USCDI) Indication
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	Indication	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:instruction		0..1	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:supplyOrder		0..1	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply	C	1..1	MedicationSupplyOrder	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:medicationDispense		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply	C	1..1	MedicationDispense	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-repeatNumber: SHOULD contain repeatNumber should-quantity: SHOULD contain quantity
entryRelationship:reaction		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: CAUS
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	ReactionObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:drugMonitoring		0..1	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	DrugMonitoringAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:substanceAdministered		0..*	EntryRelationship	The following entryRelationship is used to indicate a given medication's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		1..1	bl	Fixed Value: true
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	SubstanceAdministeredAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:adherence		0..*	EntryRelationship	(USCDI) Medication Adherence
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	MedicationAdherence	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-informant: SHOULD contain informant
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:signature		0..*	EntryRelationship	(USCDI) Medication Instructions
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	MedicationFreeTextSig	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
supply		0..1	Supply
reference		0..*	Reference
precondition		0..*	Precondition
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: PRCN
criterion		1..1	PreconditionforSubstanceAdministration	Base for all types and resources
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
SubstanceAdministration.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.templateId:medication-activity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.classCode	required	Fixed Value: SBADM http://hl7.org/cda/stds/core/ValueSet/CDAActClass
SubstanceAdministration.moodCode	required	MoodCodeEvnInt http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.18 from https://vsac.nlm.nih.gov
SubstanceAdministration.code	example	CDAActSubstanceAdministrationCode http://hl7.org/cda/stds/core/ValueSet/CDAActSubstanceAdministrationCode
SubstanceAdministration.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
SubstanceAdministration.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
SubstanceAdministration.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
SubstanceAdministration.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
SubstanceAdministration.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
SubstanceAdministration.statusCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.statusCode.code	required	MedicationStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.11 from https://vsac.nlm.nih.gov
SubstanceAdministration.effectiveTime:duration.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.effectiveTime:duration.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.effectiveTime:periodicFrequency.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.effectiveTime:periodicFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.effectiveTime:eventFrequency.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.effectiveTime:eventFrequency.operator	required	Pattern: A http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
SubstanceAdministration.routeCode	required	SPLDrugRouteOfAdministrationTerminology http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.7 from https://vsac.nlm.nih.gov
SubstanceAdministration.routeCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.routeCode.translation	preferred	MedicationRoute http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.12 from https://vsac.nlm.nih.gov
SubstanceAdministration.approachSiteCode	required	BodySiteValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.3221.8.9 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.doseQuantity.unit	preferred	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.doseQuantity.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.rateQuantity.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.rateQuantity.unit	required	UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.12839 from https://vsac.nlm.nih.gov
SubstanceAdministration.rateQuantity.operator	required	CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator
SubstanceAdministration.administrationUnitCode	required	AdministrationUnitDoseForm http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.30 from https://vsac.nlm.nih.gov
SubstanceAdministration.consumable.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.consumable.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.consumable.typeCode	required	Fixed Value: CSM http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
SubstanceAdministration.participant:drugVehicle.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeCode	required	Fixed Value: CSM http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
SubstanceAdministration.participant:drugVehicle.contextControlCode	required	Fixed Value: OP http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
SubstanceAdministration.entryRelationship:indication.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeCode	required	Fixed Value: RSON http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:instruction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeCode	required	Fixed Value: SUBJ http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:supplyOrder.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:supplyOrder.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:supplyOrder.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:medicationDispense.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:medicationDispense.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:medicationDispense.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:reaction.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:reaction.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:reaction.typeCode	required	Fixed Value: CAUS http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:drugMonitoring.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:drugMonitoring.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:drugMonitoring.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:substanceAdministered.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdministered.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdministered.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:adherence.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:adherence.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:adherence.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.entryRelationship:signature.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:signature.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.entryRelationship:signature.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
SubstanceAdministration.precondition.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.precondition.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
SubstanceAdministration.precondition.typeCode	required	Fixed Value: PRCN http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	SubstanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it **SHALL** contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
1098-32890	error	SubstanceAdministration.effectiveTime:duration	This effectiveTime **SHALL** contain either a low or a @value but not both (CONF:1098-32890). : (value.exists() or low.exists()) and ((value.exists() and low.exists()).not())
dose-unit-or-admin-unit	error	SubstanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
indication-value	error	SubstanceAdministration.entryRelationship:indication.observation	If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry. : value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
product-choice	error	SubstanceAdministration.consumable.manufacturedProduct	manufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present) : (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choice	error	SubstanceAdministration.participant:drugVehicle.participantRole	playingDevice and playingEntity are mutually exclusive : (playingDevice | playingEntity).count() <= 1
should-author	warning	SubstanceAdministration	SHOULD contain author : author.exists()
should-effectiveTime	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	SubstanceAdministration.entryRelationship:adherence.observation	SHOULD contain informant : informant.exists()
should-low	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain low : low.exists()
should-quantity	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain quantity : quantity.exists()
should-repeatNumber	warning	SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply	SHOULD contain repeatNumber : repeatNumber.exists()
should-routeCode	warning	SubstanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-text-ref-value	warning	SubstanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	SubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:supplyOrder.supply, SubstanceAdministration.entryRelationship:medicationDispense.supply, SubstanceAdministration.entryRelationship:reaction.observation, SubstanceAdministration.entryRelationship:drugMonitoring.act, SubstanceAdministration.entryRelationship:substanceAdministered.act, SubstanceAdministration.entryRelationship:adherence.observation, SubstanceAdministration.entryRelationship:signature.substanceAdministration	SHOULD contain text/reference/@value : text.reference.value.exists()
should-translation	warning	SubstanceAdministration.routeCode	SHOULD contain translation : translation.exists()
should-unit	warning	SubstanceAdministration.doseQuantity	SHOULD contain @unit : nullFlavor.exists() or unit.exists()
should-value-att	warning	SubstanceAdministration.effectiveTime:duration	SHOULD contain @value : value.exists()
value-starts-octothorpe	error	SubstanceAdministration.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from SubstanceAdministration

Summary

Mandatory: 10 elements(15 nested mandatory elements)
Fixed: 12 elements

Structures

This structure refers to these other structures:

• Medication Information (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationInformation)
• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)
• Drug Vehicle (http://hl7.org/cda/us/ccda/StructureDefinition/DrugVehicle)
• Indication (http://hl7.org/cda/us/ccda/StructureDefinition/Indication)
• Instruction (http://hl7.org/cda/us/ccda/StructureDefinition/Instruction)
• Medication Supply Order (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationSupplyOrder)
• Medication Dispense (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationDispense)
• Reaction Observation (http://hl7.org/cda/us/ccda/StructureDefinition/ReactionObservation)
• Drug Monitoring Act (http://hl7.org/cda/us/ccda/StructureDefinition/DrugMonitoringAct)
• Substance Administered Act (http://hl7.org/cda/us/ccda/StructureDefinition/SubstanceAdministeredAct)
• Medication Adherence (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationAdherence)
• Medication Free Text Sig (http://hl7.org/cda/us/ccda/StructureDefinition/MedicationFreeTextSig)
• Precondition for Substance Administration (http://hl7.org/cda/us/ccda/StructureDefinition/PreconditionforSubstanceAdministration)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of SubstanceAdministration.templateId
• The element 1 is sliced based on the value of SubstanceAdministration.effectiveTime
• The element 1 is sliced based on the value of SubstanceAdministration.participant
• The element 4 is sliced based on the values of SubstanceAdministration.entryRelationship