Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
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	(USCDI) 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(6.1.0))	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(6.1.0) | US Core PractitionerRole Profile(6.1.0) | US Core Organization Profile(6.1.0))	Individual or device performing the dispense
location		0..1	Reference(US Core Location Profile(6.1.0))	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	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.category	required	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept	required	FDANationalDrugCode http://hl7.org/fhir/us/davinci-pdex/ValueSet/FDANationalDrugCode from this IG
MedicationDispense.type	required	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
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
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	?!SΣC	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]	SΣ	1..1	CodeableConcept	(USCDI) What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept	SΣ	1..1	CodeableConcept	Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	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	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(6.1.0) | US Core Organization Profile(6.1.0))	Individual or device performing the dispense
location		0..1	Reference(US Core Location Profile(6.1.0))	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(US Core MedicationRequest Profile(6.1.0))	(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity	SC	0..1	SimpleQuantity	Billing, service, product, or drug code Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
daysSupply		0..1	SimpleQuantity	Medication expressed as a timing amount.
whenHandedOver	SC	0..1	dateTime	(USCDI) When product was given out or mailed
dosageInstruction	S	0..*	Dosage	(USCDI) 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	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
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	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.category	required	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	required	FDANationalDrugCode http://hl7.org/fhir/us/davinci-pdex/ValueSet/FDANationalDrugCode from this IG
MedicationDispense.type	required	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
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	?!SΣC	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]	SΣ	1..1	CodeableConcept	(USCDI) What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept	SΣ	1..1	CodeableConcept	Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	The patient who is prescribed the medication
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
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(6.1.0) S | US Core PractitionerRole Profile(6.1.0) | US Core Organization Profile(6.1.0) S)	Individual or device performing the dispense
location		0..1	Reference(US Core Location Profile(6.1.0))	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(US Core MedicationRequest Profile(6.1.0))	(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity	SC	0..1	SimpleQuantity	Billing, service, product, or drug code Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
daysSupply		0..1	SimpleQuantity	Medication expressed as a timing amount.
whenPrepared	Σ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(USCDI) 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	(USCDI) 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	SΣ	0..1	string	(USCDI) 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	SΣ	0..1	Timing	(USCDI) 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	SΣ	0..*	Element	(USCDI) 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]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
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	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	required	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	required	FDANationalDrugCode http://hl7.org/fhir/us/davinci-pdex/ValueSet/FDANationalDrugCode from this IG
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	required	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationDispense.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationDispense.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationDispense.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Summary

Mandatory: 1 element
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• 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)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

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]

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
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	(USCDI) 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(6.1.0))	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(6.1.0) | US Core PractitionerRole Profile(6.1.0) | US Core Organization Profile(6.1.0))	Individual or device performing the dispense
location		0..1	Reference(US Core Location Profile(6.1.0))	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	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.category	required	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept	required	FDANationalDrugCode http://hl7.org/fhir/us/davinci-pdex/ValueSet/FDANationalDrugCode from this IG
MedicationDispense.type	required	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
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
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	?!SΣC	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]	SΣ	1..1	CodeableConcept	(USCDI) What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept	SΣ	1..1	CodeableConcept	Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	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	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(6.1.0) | US Core Organization Profile(6.1.0))	Individual or device performing the dispense
location		0..1	Reference(US Core Location Profile(6.1.0))	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(US Core MedicationRequest Profile(6.1.0))	(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity	SC	0..1	SimpleQuantity	Billing, service, product, or drug code Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
daysSupply		0..1	SimpleQuantity	Medication expressed as a timing amount.
whenHandedOver	SC	0..1	dateTime	(USCDI) When product was given out or mailed
dosageInstruction	S	0..*	Dosage	(USCDI) 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	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
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	Conformance	ValueSet	URI
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.category	required	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	required	FDANationalDrugCode http://hl7.org/fhir/us/davinci-pdex/ValueSet/FDANationalDrugCode from this IG
MedicationDispense.type	required	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	USCoreMedicationDispenseProfile	Dispensing a medication to a named patient mdd-1: whenHandedOver cannot be before whenPrepared us-core-20: whenHandedOver SHALL be present if the status is "completed"
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
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	?!SΣC	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]	SΣ	1..1	CodeableConcept	(USCDI) What medication was supplied Slice: Unordered, Closed by type:$this Binding: Medication Clinical Drug (extensible)
medication[x]:medicationCodeableConcept	SΣ	1..1	CodeableConcept	Billing, service, product, or drug code Binding: FDA National Drug Code (NDC) (required)
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	The patient who is prescribed the medication
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
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(6.1.0) S | US Core PractitionerRole Profile(6.1.0) | US Core Organization Profile(6.1.0) S)	Individual or device performing the dispense
location		0..1	Reference(US Core Location Profile(6.1.0))	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(US Core MedicationRequest Profile(6.1.0))	(USCDI) Medication order that authorizes the dispense
type	S	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (required)
quantity	SC	0..1	SimpleQuantity	Billing, service, product, or drug code Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
daysSupply		0..1	SimpleQuantity	Medication expressed as a timing amount.
whenPrepared	Σ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver	SC	0..1	dateTime	(USCDI) 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	(USCDI) 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	SΣ	0..1	string	(USCDI) 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	SΣ	0..1	Timing	(USCDI) 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	SΣ	0..*	Element	(USCDI) 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]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
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	Conformance	ValueSet	URI
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationDispense.status	required	MedicationDispense Status Codes http://hl7.org/fhir/ValueSet/medicationdispense-status from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	required	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationDispense.medication[x]:medicationCodeableConcept	required	FDANationalDrugCode http://hl7.org/fhir/us/davinci-pdex/ValueSet/FDANationalDrugCode from this IG
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.type	required	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.quantity	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationDispense.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationDispense.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationDispense.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationDispense.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationDispense.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Summary

Mandatory: 1 element
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• 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)
• SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

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]