Patient reports they are taking Tylenol PM and has the bottle

{
  "resourceType" : "MedicationStatement",
  "id" : "example001",
  "contained" : [{
    "resourceType" : "Medication",
    "id" : "med0309",
    "code" : {
      "coding" : [{
        "system" : "http://hl7.org/fhir/sid/ndc",
        "code" : "50580-608-02",
        "display" : "Tylenol PM Extra Strength, 1 BOTTLE in 1 CARTON (50580-608-02) > 100 TABLET, FILM COATED in 1 BOTTLE (package)"
      }],
      "text" : "Tylenol PM"
    },
    "doseForm" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "385057009",
        "display" : "Film-coated tablet (basic dose form)"
      }]
    },
    "ingredient" : [{
      "item" : {
        "concept" : {
          "coding" : [{
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "315266",
            "display" : "Acetaminophen 500 MG"
          }]
        }
      },
      "strengthRatio" : {
        "numerator" : {
          "value" : 500,
          "system" : "http://unitsofmeasure.org",
          "code" : "mg"
        },
        "denominator" : {
          "value" : 1,
          "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
          "code" : "TAB"
        }
      }
    },
    {
      "item" : {
        "concept" : {
          "coding" : [{
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "901813",
            "display" : "Diphenhydramine Hydrochloride 25 mg"
          }]
        }
      },
      "strengthRatio" : {
        "numerator" : {
          "value" : 25,
          "system" : "http://unitsofmeasure.org",
          "code" : "mg"
        },
        "denominator" : {
          "value" : 1,
          "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
          "code" : "TAB"
        }
      }
    }],
    "batch" : {
      "lotNumber" : "9494788",
      "expirationDate" : "2017-05-22"
    }
  }],
  "identifier" : [{
    "use" : "official",
    "system" : "http://www.bmc.nl/portal/medstatements",
    "value" : "12345689"
  }],
  "status" : "recorded",
  "category" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/medication-statement-category",
      "code" : "inpatient",
      "display" : "Inpatient"
    }]
  }],
  "medication" : {
    "reference" : {
      "reference" : "#med0309"
    }
  },
  "subject" : {
    "reference" : "Patient/pat1",
    "display" : "Donald Duck"
  },
  "effectiveDateTime" : "2015-01-23",
  "dateAsserted" : "2015-02-22",
  "informationSource" : [{
    "reference" : "Patient/pat1",
    "display" : "Donald Duck"
  }],
  "derivedFrom" : [{
    "reference" : "MedicationRequest/medrx002"
  }],
  "reason" : [{
    "concept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "32914008",
        "display" : "Restless Legs"
      }]
    }
  }],
  "note" : [{
    "text" : "Patient indicates they miss the occasional dose"
  }],
  "dosage" : [{
    "sequence" : 1,
    "text" : "1-2 tablets once daily at bedtime as needed for restless legs",
    "additionalInstruction" : [{
      "text" : "Taking at bedtime"
    }],
    "timing" : {
      "repeat" : {
        "frequency" : 1,
        "period" : 1,
        "periodUnit" : "d"
      }
    },
    "asNeededFor" : [{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "32914008",
        "display" : "Restless Legs"
      }]
    }],
    "route" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "26643006",
        "display" : "Oral Route"
      }]
    },
    "doseAndRate" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
          "code" : "ordered",
          "display" : "Ordered"
        }]
      },
      "doseRange" : {
        "low" : {
          "value" : 1,
          "unit" : "TAB",
          "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
          "code" : "TAB"
        },
        "high" : {
          "value" : 2,
          "unit" : "TAB",
          "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
          "code" : "TAB"
        }
      }
    }]
  }]
}