US Meds Implementation Guide (Release 1.2.0)

This page is part of the US-Medication FHIR IG (v1.2.0: STU 2) based on FHIR R3. This is the current published version. For a full list of available versions, see the Directory of published versions

Example: StructureDefinition-medicationdispense

Formats: Narrative, XML, JSON, Turtle

Raw xml


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="medicationdispense"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense" title="Dispense that a medication is/was actively taken by a patient.">MedicationDispense</a><a name="MedicationDispense"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense.status">status</a><a name="MedicationDispense.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/datatypes.html#code">code</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/valueset-medication-dispense-status.html">MedicationDispenseStatus</a> (<a href="http://hl7.org/fhir/terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set">required</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_choice.gif" alt="." style="background-color: white; background-color: inherit" title="Choice of Types" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense.medication[x]">medication[x]</a><a name="MedicationDispense.medication_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/datatypes.html#CodeableConcept">CodeableConcept</a>, <a href="http://hl7.org/fhir/references.html">Reference</a>(<a href="http://hl7.org/fhir/us/core/STU1//StructureDefinition-us-core-medication.html">US  Core Medication Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/us/core/STU1//ValueSet-us-core-medication-codes.html">Medication Clinical Drug (RxNorm)</a> (<a href="http://hl7.org/fhir/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense.subject">subject</a><a name="MedicationDispense.subject"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/references.html">Reference</a>(<a href="http://hl7.org/fhir/us/core/STU1//StructureDefinition-us-core-patient.html">US Core Patient Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense.performer">performer</a><a name="MedicationDispense.performer"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense.performer.actor">actor</a><a name="MedicationDispense.performer.actor"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/references.html">Reference</a>(http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract), <a href="http://hl7.org/fhir/references.html">Reference</a>(<a href="http://hl7.org/fhir/us/core/STU1//StructureDefinition-us-core-organization.html">US Core Organization Core Profile</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense.whenHandedOver">whenHandedOver</a><a name="MedicationDispense.whenHandedOver"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-medicationdispense-definitions.html#MedicationDispense.dosageInstruction">dosageInstruction</a><a name="MedicationDispense.dosageInstruction"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span>..<span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/datatypes.html#Dosage">Dosage</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://hl7.org/fhir/us/meds/StructureDefinition/medicationdispense"/>
  <version value="1.0.0"/>
  <name value="MedicationDispense Profile"/>
  <status value="draft"/>
  <date value="2017-03-07T00:00:00+11:00"/>
  <publisher value="Health Level Seven International Pharmacy Work Group"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/medication/index.cfm"/>
    </telecom>
  </contact>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="MedicationDispense"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="MedicationDispense">
      <path value="MedicationDispense"/>
      <short value="Dispensing a medication to a named patient"/>
      <definition
                  value="Dispense that a medication is/was actively taken by a patient."/>
      <comment
               value="The WG will be updating the MedicationDispense resource  to adjust each affected resource to align with the workflow pattern (see workflow.html)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="mdd-1"/>
        <severity value="error"/>
        <human value="whenHandedOver cannot be before whenPrepared"/>
        <expression
                    value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver &gt;= whenPrepared"/>
        <xpath
               value="not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value &gt;= f:whenPrepared/@value)"/>
        <source value="MedicationDispense"/>
      </constraint>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="..Event"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Supply[moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.medication"/>
      </mapping>
    </element>
    <element id="MedicationDispense.id">
      <path value="MedicationDispense.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="MedicationDispense.meta">
      <path value="MedicationDispense.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="MedicationDispense.implicitRules">
      <path value="MedicationDispense.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="MedicationDispense.language">
      <path value="MedicationDispense.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="MedicationDispense.text">
      <path value="MedicationDispense.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="MedicationDispense.contained">
      <path value="MedicationDispense.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.extension">
      <path value="MedicationDispense.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.modifierExtension">
      <path value="MedicationDispense.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.identifier">
      <path value="MedicationDispense.identifier"/>
      <short value="External identifier"/>
      <definition
                  value="Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="…identifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="MedicationDispense.partOf">
      <path value="MedicationDispense.partOf"/>
      <short value="Event that dispense is part of"/>
      <definition value="The procedure that the dispense is done because of."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.partOf"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="…part of"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/>
      <short
             value="preparation | in-progress | on-hold | completed | entered-in-error | stopped"/>
      <definition
                  value="A code specifying the state of the set of dispense events."/>
      <comment
               value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.status"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description
                     value="A set of codes indicating the current status of a MedicationDispense."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/medication-dispense-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="…status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".statusCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="MedicationDispense.category">
      <path value="MedicationDispense.category"/>
      <short value="Type of medication dispense"/>
      <definition
                  value="Indicates type of medication dispense and where the medication is expected to be consumed or administered."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.category"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseCategory"/>
        </extension>
        <strength value="preferred"/>
        <description
                     value="A code describing where the dispensed medication is expected to be consumed or administered"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/medication-dispense-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type of medication dispense&quot;].value"/>
      </mapping>
    </element>
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/>
      <short value="What medication was supplied"/>
      <definition
                  value="Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications."/>
      <comment
               value="If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended.  For example if you require form or lot number, then you must reference the Medication resource. ."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.medication[x]"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <description value="Prescribable medications"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/us-core-medication-codes"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="…code"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-2-Dispense/Give Code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRD].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element id="MedicationDispense.subject">
      <path value="MedicationDispense.subject"/>
      <short value="Who the dispense is for"/>
      <definition
                  value="A link to a resource representing the person or the group to whom the medication will be given."/>
      <comment value="SubstanceAdministration-&gt;subject-&gt;Patient."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="…subject"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3-Patient ID List"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="MedicationDispense.context">
      <path value="MedicationDispense.context"/>
      <short value="Encounter / Episode associated with event"/>
      <definition
                  value="The encounter or episode of care that establishes the context for this event."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.context"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="…context"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type of encounter or episode&quot;]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.supportingInformation">
      <path value="MedicationDispense.supportingInformation"/>
      <short value="Information that supports the dispensing of the medication"/>
      <definition
                  value="Additional information that supports the medication being dispensed."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.supportingInformation"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element id="MedicationDispense.performer">
      <path value="MedicationDispense.performer"/>
      <short value="Who performed event"/>
      <definition
                  value="Indicates who or what performed the event.  It should be assumed that the performer is the dispenser of the medication."/>
      <comment value="The performer will be reviewed as part of STU4."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mustSupport value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="…performer"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.performer.id">
      <path value="MedicationDispense.performer.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationDispense.performer.extension">
      <path value="MedicationDispense.performer.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationDispense.performer.modifierExtension">
      <path value="MedicationDispense.performer.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.performer.actor">
      <path value="MedicationDispense.performer.actor"/>
      <short value="Individual who was performing"/>
      <definition
                  value="The device, practitioner, etc. who performed the action.  It should be assumed that the actor is the dispenser of the medication."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.performer.actor"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="….actor"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".role"/>
      </mapping>
    </element>
    <element id="MedicationDispense.performer.onBehalfOf">
      <path value="MedicationDispense.performer.onBehalfOf"/>
      <short value="Organization organization was acting for"/>
      <definition
                  value="The organization the device or practitioner was acting on behalf of."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.performer.onBehalfOf"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="….onBehalfOf"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".role.scopingOrganization"/>
      </mapping>
    </element>
    <element id="MedicationDispense.authorizingPrescription">
      <path value="MedicationDispense.authorizingPrescription"/>
      <short value="Medication order that authorizes the dispense"/>
      <definition
                  value="Indicates the medication order that is being dispensed against."/>
      <comment value="Maps to basedOn in Event logical model."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.authorizingPrescription"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="…basedOn"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="ORC-2 Placer Order Number"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.type">
      <path value="MedicationDispense.type"/>
      <short value="Trial fill, partial fill, emergency fill, etc."/>
      <definition
                  value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseType"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-33-Dispense Type"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MedicationDispense.quantity">
      <path value="MedicationDispense.quantity"/>
      <short value="Amount dispensed"/>
      <definition
                  value="The amount of medication that has been dispensed. Includes unit of measure."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.quantity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map
             value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".quantity"/>
      </mapping>
    </element>
    <element id="MedicationDispense.daysSupply">
      <path value="MedicationDispense.daysSupply"/>
      <short value="Amount of medication expressed as a timing amount"/>
      <definition value="The amount of medication expressed as a timing amount."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.daysSupply"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map
             value="TQ1.6 Timing/Quantity Segment Service Duration.
Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component.  This is a formatted string, first character for the time unit (e.g., D=days), followed by the value.  For example, “D14” represents “14 days supply”
From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration.  This is a CQ data type (&lt;Quantity (NM)&gt; ^ &lt;Units (CWE)&gt;), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^
For backwards compatibility, ORC.7 was permitted through v2.6.  Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveUseTime"/>
      </mapping>
    </element>
    <element id="MedicationDispense.whenPrepared">
      <path value="MedicationDispense.whenPrepared"/>
      <short value="When product was packaged and reviewed"/>
      <definition
                  value="The time when the dispensed product was packaged and reviewed."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.whenPrepared"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-3-Date/Time Dispensed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime[xmi:type=IVL_TS].low"/>
      </mapping>
    </element>
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/>
      <short value="When product was given out"/>
      <definition
                  value="The time the dispensed product was provided to the patient or their representative."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.whenHandedOver"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="…occurrenceDateTime"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-3-Date/Time Dispensed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime[xmi:type=IVL_TS].high"/>
      </mapping>
    </element>
    <element id="MedicationDispense.destination">
      <path value="MedicationDispense.destination"/>
      <short value="Where the medication was sent"/>
      <definition
                  value="Identification of the facility/location where the medication was shipped to, as part of the dispense event."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.destination"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map
             value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=DST].role"/>
      </mapping>
    </element>
    <element id="MedicationDispense.receiver">
      <path value="MedicationDispense.receiver"/>
      <short value="Who collected the medication"/>
      <definition
                  value="Identifies the person who picked up the medication.  This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.receiver"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=RCV].role"/>
      </mapping>
    </element>
    <element id="MedicationDispense.note">
      <path value="MedicationDispense.note"/>
      <short value="Information about the dispense"/>
      <definition
                  value="Extra information about the dispense that could not be conveyed in the other attributes."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="…note"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="RXD-9 Dispense Notes"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/>
      <short
             value="How the medication is to be used by the patient or administered by the caregiver"/>
      <definition
                  value="Indicates how the medication is to be used by the patient."/>
      <comment
               value="When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates.
The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.dosageInstruction"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Dosage"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution">
      <path value="MedicationDispense.substitution"/>
      <short value="Whether a substitution was performed on the dispense"/>
      <definition
                  value="Indicates whether or not substitution was made as part of the dispense.  In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen.  This block explains what substitution did or did not happen and why.  If nothing is specified, substitution was not done."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.substitution"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.id">
      <path value="MedicationDispense.substitution.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.extension">
      <path value="MedicationDispense.substitution.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.modifierExtension">
      <path value="MedicationDispense.substitution.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.wasSubstituted">
      <path value="MedicationDispense.substitution.wasSubstituted"/>
      <short
             value="Whether a substitution was or was not performed on the dispense"/>
      <definition
                  value="True if the dispenser dispensed a different drug or product from what was prescribed."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.substitution.wasSubstituted"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".actionNegationInd"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.type">
      <path value="MedicationDispense.substitution.type"/>
      <short
             value="Code signifying whether a different drug was dispensed from what was prescribed"/>
      <definition
                  value="A code signifying whether a different drug was dispensed from what was prescribed."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.substitution.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionType"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.reason">
      <path value="MedicationDispense.substitution.reason"/>
      <short value="Why was substitution made"/>
      <definition
                  value="Indicates the reason for the substitution of (or lack of substitution) from what was prescribed."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.substitution.reason"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
    </element>
    <element id="MedicationDispense.substitution.responsibleParty">
      <path value="MedicationDispense.substitution.responsibleParty"/>
      <short value="Who is responsible for the substitution"/>
      <definition
                  value="The person or organization that has primary responsibility for the substitution."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.substitution.responsibleParty"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/>
      </mapping>
    </element>
    <element id="MedicationDispense.detectedIssue">
      <path value="MedicationDispense.detectedIssue"/>
      <short value="Clinical issue with action"/>
      <definition
                  value="Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. Drug-drug interaction, duplicate therapy, dosage alert etc."/>
      <alias value="Contraindication"/>
      <alias value="Drug Utilization Review (DUR)"/>
      <alias value="Alert"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.detectedIssue"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"/>
      </mapping>
    </element>
    <element id="MedicationDispense.notDone">
      <path value="MedicationDispense.notDone"/>
      <short value="Whether the dispense was or was not performed"/>
      <definition
                  value="True if the dispense was not performed for some reason."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.notDone"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="…notDone"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".actionNegationInd"/>
      </mapping>
    </element>
    <element id="MedicationDispense.notDoneReason[x]">
      <path value="MedicationDispense.notDoneReason[x]"/>
      <short value="Why a dispense was not performed"/>
      <definition value="Indicates the reason why a dispense was not performed."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MedicationDispense.notDoneReason[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/>
      </type>
      <mapping>
        <identity value="workflow"/>
        <map value="…notDoneReason"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;not done reason&quot;].value"/>
      </mapping>
    </element>
    <element id="MedicationDispense.eventHistory">
      <path value="MedicationDispense.eventHistory"/>
      <short value="A list of releveant lifecycle events"/>
      <definition
                  value="A summary of the events of interest that have occurred, such as when the dispense was verified."/>
      <comment
               value="This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MedicationDispense.eventHistory"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Provenance"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="MedicationDispense">
      <path value="MedicationDispense"/>
      <definition
                  value="Dispense that a medication is/was actively taken by a patient."/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
    </element>
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <strength value="required"/>
        <description
                     value="A set of codes indicating the current status of a MedicationDispense."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/medication-dispense-status"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <strength value="extensible"/>
        <description value="Prescribable medications"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/us-core-medication-codes"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="MedicationDispense.subject">
      <path value="MedicationDispense.subject"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="MedicationDispense.performer">
      <path value="MedicationDispense.performer"/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="MedicationDispense.performer.actor">
      <path value="MedicationDispense.performer.actor"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-pract"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Dosage"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
  </differential>
</StructureDefinition>