This page is part of the US Prescription Drug Monitoring Program (PDMP) (v1.0.0-ballot: STU1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

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: pdmp-meddispense-1 - XML Representation

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<MedicationDispense xmlns="http://hl7.org/fhir">
  <id value="pdmp-meddispense-1"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2023-06-05T06:38:52Z"/>
    <source value="http://example.org/ma-pdmp"/>
    <profile
             value="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-medicationdispense"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A record of a medication that was dispensed to the patient identified in the PDMP request: August Samuels</div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number">
    <valuePositiveInt value="1"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method">
    <valueCoding>
      <system
              value="http://hl7.org/fhir/us/pdmp/CodeSystem/temporary-pmix-transmission-form-of-rx-origin"/>
      <code value="05"/>
      <display value="Electronic Prescription"/>
    </valueCoding>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme">
    <valueDecimal value="18"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment">
    <valueCoding>
      <system
              value="http://hl7.org/fhir/us/pdmp/CodeSystem/temporary-pmix-method-of-payment"/>
      <code value="01"/>
      <display value="Private Pay (Cash, Charge, Credit Card)"/>
    </valueCoding>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code">
    <valueCoding>
      <system
              value="http://hl7.org/fhir/us/pdmp/CodeSystem/temporary-pmix-opioid-treatment-code"/>
      <code value="10"/>
      <display value="Acute Opioid Therapy"/>
    </valueCoding>
  </extension>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="FILL"/>
        <display value="Filler Identifier"/>
      </coding>
    </type>
    <system value="http://ourpharmacy.com/fillnumber"/>
    <value value="2000353"/>
  </identifier>
  <status value="completed"/>
  <medicationCodeableConcept>
    <coding>
      <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
      <code value="993781"/>
      <display
               value="acetaminophen 300 MG / codeine phosphate 30 MG Oral Tablet"/>
    </coding>
    <coding>
      <system value="http://hl7.org/fhir/sid/ndc"/>
      <code value="00093015001"/>
      <userSelected value="true"/>
    </coding>
    <text value="Acetaminophen 300 mg / Codeine 30 mg oral tablet"/>
  </medicationCodeableConcept>
  <subject>
    <reference value="urn:uuid:53a1e123-5b56-44ae-b7e8-36e0b9800f57"/>
    <display value="August Samuels"/>
  </subject>
  <performer>
    <actor>
      <reference value="urn:uuid:82ae67e4-f23a-4c17-b80a-9076a37f5d6e"/>
      <identifier>
        <system
                value="http://terminology.hl7.org/CodeSystem/NCPDPProviderIdentificationNumber"/>
        <value value="999017"/>
      </identifier>
      <display value="Our Pharmacy"/>
    </actor>
  </performer>
  <authorizingPrescription>
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="FILL"/>
          <display value="Filler Identifier"/>
        </coding>
      </type>
      <system value="http://mypharmacysystem.com/prescriptionnumber"/>
      <value value="065046045550"/>
    </identifier>
  </authorizingPrescription>
  <quantity>
    <value value="15"/>
    <unit value="each"/>
  </quantity>
  <daysSupply>
    <value value="5"/>
  </daysSupply>
  <whenPrepared value="2023-06-05"/>
  <whenHandedOver>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
      <valueCode value="unknown"/>
    </extension>
  </whenHandedOver>
  <dosageInstruction>
    <sequence value="1"/>
    <text value="1 tablet every 6-8 hours as needed for pain"/>
  </dosageInstruction>
</MedicationDispense>