Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## Resource Profile: PDex MedicationDispense ( Experimental )

Official URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-medicationdispense | Version: 2.1.1
Standards status: Informative | Computable Name: PdexMedicationDispense
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

Prescription Medications dispensed by a pharmacy to a health plan member and paid for in full, or in part, by the health plan

Usages:

- Examples for this Profile: MedicationDispense/1000001
- CapabilityStatements using this Profile: PDex Server CapabilityStatement with US core 6.1 support and PDEX Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile(7.0.0) | Dispensing a medication to a named patient Constraints: mdd-1, us-core-20
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:refillNum |  | 0..1 | Quantity | Refill number of this prescription URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ C | 1..1 | code | completed Binding: MedicationDispense Status Codes (required)
category |  | 0..1 | CodeableConcept | Type of dispense action Binding: MedicationDispense Category Codes (required)
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S) | The patient who is prescribed the medication
context | S | 0..1 | Reference(US Core Encounter Profile(7.0.0) S | EpisodeOfCare) | Encounter associated with MedicationDispense
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication. Reference any US Core, HRex or PDex profile.
performer | S | 0..* | BackboneElement | Who performed the dispense event
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
actor | S | 1..1 | Reference(US Core Practitioner Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core Organization Profile(7.0.0) S) | Individual or device performing the dispense
location |  | 0..1 | Reference(US Core Location Profile(7.0.0)) | Where the dispense occurred
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile(7.0.0)) | Medication order that authorizes the dispense
type | S | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity | S | 0..1 | SimpleQuantity | Billing, service, product, or drug code Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
daysSupply |  | 0..1 | SimpleQuantity | Medication expressed as a timing amount.
whenHandedOver | S C | 0..1 | dateTime | When product was given out or mailed
dosageInstruction | S | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
substitution | S | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted | S | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.status | Base | required | Medication dispense status codes | 📦4.0.1 | FHIR Std.
MedicationDispense.category | Base | required | Medication dispense category codes | 📦4.0.1 | FHIR Std.
MedicationDispense.medication[x] | Base | extensible | Medication Clinical Drug | 📦20240606 | VSAC v0.21
MedicationDispense.medication[x]:medicationCodeableConcept | Base | required | FDA National Drug Code (NDC) | 📦2.1.1 | This IG
MedicationDispense.type | Base | required | ActPharmacySupplyType | 📦3.0.0 | THO v6.3
MedicationDispense.quantity | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from USCoreMedicationDispenseProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense |  | 0..* | USCoreMedicationDispenseProfile(7.0.0) | Dispensing a medication to a named patient
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:refillNum |  | 0..1 | Quantity | Refill number of this prescription URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill
status |  | 1..1 | code | completed Binding: MedicationDispense Status Codes (required)
category |  | 0..1 | CodeableConcept | Type of dispense action Binding: MedicationDispense Category Codes (required)
Slices for medication[x] |  | 1..1 | CodeableConcept | What medication was supplied Slice: Unordered, Open by type:$this
medication[x]:medicationCodeableConcept |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject |  | 1..1 | Reference(US Core Patient Profile(7.0.0)) | The patient who is prescribed the medication
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication. Reference any US Core, HRex or PDex profile.
performer |  | 0..* | BackboneElement | Who performed the dispense event
actor |  | 1..1 | Reference(US Core Practitioner Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core Organization Profile(7.0.0)) | Individual or device performing the dispense
location |  | 0..1 | Reference(US Core Location Profile(7.0.0)) | Where the dispense occurred
type |  | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity |  | 0..1 | SimpleQuantity | Billing, service, product, or drug code
daysSupply |  | 0..1 | SimpleQuantity | Medication expressed as a timing amount.
substitution | S | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
wasSubstituted | S | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.status | Base | required | Medication dispense status codes | 📦4.0.1 | FHIR Std.
MedicationDispense.category | Base | required | Medication dispense category codes | 📦4.0.1 | FHIR Std.
MedicationDispense.medication[x]:medicationCodeableConcept | Base | required | FDA National Drug Code (NDC) | 📦2.1.1 | This IG
MedicationDispense.type | Base | required | ActPharmacySupplyType | 📦3.0.0 | THO v6.3

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile(7.0.0) | Dispensing a medication to a named patient Constraints: mdd-1, us-core-20
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:refillNum |  | 0..1 | Quantity | Refill number of this prescription URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External identifier
partOf |  | 0..* | Reference(Procedure) | Event that dispense is part of
status | ?!S Σ C | 1..1 | code | completed Binding: MedicationDispense Status Codes (required)
statusReason[x] |  | 0..1 |  | Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept |  |  | CodeableConcept |
statusReasonReference |  |  | Reference(DetectedIssue) |
category |  | 0..1 | CodeableConcept | Type of dispense action Binding: MedicationDispense Category Codes (required)
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S) | The patient who is prescribed the medication
context | S | 0..1 | Reference(US Core Encounter Profile(7.0.0) S | EpisodeOfCare) | Encounter associated with MedicationDispense
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication. Reference any US Core, HRex or PDex profile.
performer | S | 0..* | BackboneElement | Who performed the dispense event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor | S | 1..1 | Reference(US Core Practitioner Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core Organization Profile(7.0.0) S) | Individual or device performing the dispense
location |  | 0..1 | Reference(US Core Location Profile(7.0.0)) | Where the dispense occurred
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile(7.0.0)) | Medication order that authorizes the dispense
type | S | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity | S | 0..1 | SimpleQuantity | Billing, service, product, or drug code Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
daysSupply |  | 0..1 | SimpleQuantity | Medication expressed as a timing amount.
whenPrepared | Σ | 0..1 | dateTime | When product was packaged and reviewed
whenHandedOver | S C | 0..1 | dateTime | When product was given out or mailed
destination |  | 0..1 | Reference(Location) | Where the medication was sent
receiver |  | 0..* | Reference(Patient | Practitioner) | Who collected the medication
note |  | 0..* | Annotation | Information about the dispense
dosageInstruction | S | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
substitution | S | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted | S | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
type |  | 0..1 | CodeableConcept | Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason |  | 0..* | CodeableConcept | Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty |  | 0..* | Reference(Practitioner | PractitionerRole) | Who is responsible for the substitution
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
MedicationDispense.status | Base | required | Medication dispense status codes | 📦4.0.1 | FHIR Std.
MedicationDispense.statusReason[x] | Base | example | Medication dispense status reason codes | 📦4.0.1 | FHIR Std.
MedicationDispense.category | Base | required | Medication dispense category codes | 📦4.0.1 | FHIR Std.
MedicationDispense.medication[x] | Base | extensible | Medication Clinical Drug | 📦20240606 | VSAC v0.21
MedicationDispense.medication[x]:medicationCodeableConcept | Base | required | FDA National Drug Code (NDC) | 📦2.1.1 | This IG
MedicationDispense.performer.​function | Base | example | Medication dispense performer function codes | 📦4.0.1 | FHIR Std.
MedicationDispense.type | Base | required | ActPharmacySupplyType | 📦3.0.0 | THO v6.3
MedicationDispense.quantity | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationDispense.substitution.​type | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v6.3
MedicationDispense.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v6.3

#### Constraints

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

This structure is derived from USCoreMedicationDispenseProfile

Summary

Mandatory: 1 element
Must-Support: 2 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
- US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill

Slices

This structure defines the following Slices:

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

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile(7.0.0) | Dispensing a medication to a named patient Constraints: mdd-1, us-core-20
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:refillNum |  | 0..1 | Quantity | Refill number of this prescription URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ C | 1..1 | code | completed Binding: MedicationDispense Status Codes (required)
category |  | 0..1 | CodeableConcept | Type of dispense action Binding: MedicationDispense Category Codes (required)
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S) | The patient who is prescribed the medication
context | S | 0..1 | Reference(US Core Encounter Profile(7.0.0) S | EpisodeOfCare) | Encounter associated with MedicationDispense
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication. Reference any US Core, HRex or PDex profile.
performer | S | 0..* | BackboneElement | Who performed the dispense event
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
actor | S | 1..1 | Reference(US Core Practitioner Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core Organization Profile(7.0.0) S) | Individual or device performing the dispense
location |  | 0..1 | Reference(US Core Location Profile(7.0.0)) | Where the dispense occurred
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile(7.0.0)) | Medication order that authorizes the dispense
type | S | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity | S | 0..1 | SimpleQuantity | Billing, service, product, or drug code Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
daysSupply |  | 0..1 | SimpleQuantity | Medication expressed as a timing amount.
whenHandedOver | S C | 0..1 | dateTime | When product was given out or mailed
dosageInstruction | S | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | Timing | When medication should be administered
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
substitution | S | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted | S | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.status | Base | required | Medication dispense status codes | 📦4.0.1 | FHIR Std.
MedicationDispense.category | Base | required | Medication dispense category codes | 📦4.0.1 | FHIR Std.
MedicationDispense.medication[x] | Base | extensible | Medication Clinical Drug | 📦20240606 | VSAC v0.21
MedicationDispense.medication[x]:medicationCodeableConcept | Base | required | FDA National Drug Code (NDC) | 📦2.1.1 | This IG
MedicationDispense.type | Base | required | ActPharmacySupplyType | 📦3.0.0 | THO v6.3
MedicationDispense.quantity | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.

#### Constraints

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

Differential View

This structure is derived from USCoreMedicationDispenseProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense |  | 0..* | USCoreMedicationDispenseProfile(7.0.0) | Dispensing a medication to a named patient
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:refillNum |  | 0..1 | Quantity | Refill number of this prescription URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill
status |  | 1..1 | code | completed Binding: MedicationDispense Status Codes (required)
category |  | 0..1 | CodeableConcept | Type of dispense action Binding: MedicationDispense Category Codes (required)
Slices for medication[x] |  | 1..1 | CodeableConcept | What medication was supplied Slice: Unordered, Open by type:$this
medication[x]:medicationCodeableConcept |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject |  | 1..1 | Reference(US Core Patient Profile(7.0.0)) | The patient who is prescribed the medication
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication. Reference any US Core, HRex or PDex profile.
performer |  | 0..* | BackboneElement | Who performed the dispense event
actor |  | 1..1 | Reference(US Core Practitioner Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core Organization Profile(7.0.0)) | Individual or device performing the dispense
location |  | 0..1 | Reference(US Core Location Profile(7.0.0)) | Where the dispense occurred
type |  | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity |  | 0..1 | SimpleQuantity | Billing, service, product, or drug code
daysSupply |  | 0..1 | SimpleQuantity | Medication expressed as a timing amount.
substitution | S | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
wasSubstituted | S | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.status | Base | required | Medication dispense status codes | 📦4.0.1 | FHIR Std.
MedicationDispense.category | Base | required | Medication dispense category codes | 📦4.0.1 | FHIR Std.
MedicationDispense.medication[x]:medicationCodeableConcept | Base | required | FDA National Drug Code (NDC) | 📦2.1.1 | This IG
MedicationDispense.type | Base | required | ActPharmacySupplyType | 📦3.0.0 | THO v6.3

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | USCoreMedicationDispenseProfile(7.0.0) | Dispensing a medication to a named patient Constraints: mdd-1, us-core-20
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:refillNum |  | 0..1 | Quantity | Refill number of this prescription URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External identifier
partOf |  | 0..* | Reference(Procedure) | Event that dispense is part of
status | ?!S Σ C | 1..1 | code | completed Binding: MedicationDispense Status Codes (required)
statusReason[x] |  | 0..1 |  | Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept |  |  | CodeableConcept |
statusReasonReference |  |  | Reference(DetectedIssue) |
category |  | 0..1 | CodeableConcept | Type of dispense action Binding: MedicationDispense Category Codes (required)
Slices for medication[x] | S Σ | 1..1 | CodeableConcept | What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept | S Σ | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S) | The patient who is prescribed the medication
context | S | 0..1 | Reference(US Core Encounter Profile(7.0.0) S | EpisodeOfCare) | Encounter associated with MedicationDispense
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication. Reference any US Core, HRex or PDex profile.
performer | S | 0..* | BackboneElement | Who performed the dispense event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor | S | 1..1 | Reference(US Core Practitioner Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core Organization Profile(7.0.0) S) | Individual or device performing the dispense
location |  | 0..1 | Reference(US Core Location Profile(7.0.0)) | Where the dispense occurred
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile(7.0.0)) | Medication order that authorizes the dispense
type | S | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity | S | 0..1 | SimpleQuantity | Billing, service, product, or drug code Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
daysSupply |  | 0..1 | SimpleQuantity | Medication expressed as a timing amount.
whenPrepared | Σ | 0..1 | dateTime | When product was packaged and reviewed
whenHandedOver | S C | 0..1 | dateTime | When product was given out or mailed
destination |  | 0..1 | Reference(Location) | Where the medication was sent
receiver |  | 0..* | Reference(Patient | Practitioner) | Who collected the medication
note |  | 0..* | Annotation | Information about the dispense
dosageInstruction | S | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | S Σ | 0..1 | Timing | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
substitution | S | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted | S | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
type |  | 0..1 | CodeableConcept | Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason |  | 0..* | CodeableConcept | Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty |  | 0..* | Reference(Practitioner | PractitionerRole) | Who is responsible for the substitution
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
MedicationDispense.status | Base | required | Medication dispense status codes | 📦4.0.1 | FHIR Std.
MedicationDispense.statusReason[x] | Base | example | Medication dispense status reason codes | 📦4.0.1 | FHIR Std.
MedicationDispense.category | Base | required | Medication dispense category codes | 📦4.0.1 | FHIR Std.
MedicationDispense.medication[x] | Base | extensible | Medication Clinical Drug | 📦20240606 | VSAC v0.21
MedicationDispense.medication[x]:medicationCodeableConcept | Base | required | FDA National Drug Code (NDC) | 📦2.1.1 | This IG
MedicationDispense.performer.​function | Base | example | Medication dispense performer function codes | 📦4.0.1 | FHIR Std.
MedicationDispense.type | Base | required | ActPharmacySupplyType | 📦3.0.0 | THO v6.3
MedicationDispense.quantity | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📦4.0.1 | FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationDispense.substitution.​type | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v6.3
MedicationDispense.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v6.3

#### Constraints

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

This structure is derived from USCoreMedicationDispenseProfile

Summary

Mandatory: 1 element
Must-Support: 2 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
- US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/DispenseRefill

Slices

This structure defines the following Slices:

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

Other representations of profile: CSV, Excel, Schematron