Extensions for Using Data Elements from FHIR STU3 in FHIR R4B
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Extensions for Using Data Elements from FHIR STU3 in FHIR R4B - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R3_MedicationDispense_R4B - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-MedicationDispense resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationDispense
Definition

Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

ShortDispensing a medication to a named patient
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationDispense.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. MedicationDispense.extension:notDone
    Slice NamenotDone
    Definition

    STU3: MedicationDispense.notDone (new:boolean)

    ShortSTU3: Whether the dispense was or was not performed (new)
    Comments

    Element MedicationDispense.notDone has a context of MedicationDispense based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.notDone has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(STU3: Whether the dispense was or was not performed (new)) (Extension Type: boolean)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. MedicationDispense.modifierExtension
    Definition

    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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. MedicationDispense.status
    Definition

    A code specifying the state of the set of dispense events.

    Shortpreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    BindingThe codes SHALL be taken from MedicationDispense Status Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status|4.3.0
    (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.3.0)

    Describes the lifecycle of the dispense.

    Typecode
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. MedicationDispense.status.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MedicationDispense.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 14. MedicationDispense.status.extension:status
      Slice Namestatus
      Definition

      STU3: MedicationDispense.status additional codes

      ShortSTU3: preparation | in-progress | on-hold | completed | entered-in-error | stopped additional codes
      Comments

      Element MedicationDispense.status is mapped to FHIR R4B element MedicationDispense.status as RelatedTo. The mappings for MedicationDispense.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationDispense.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(STU3: preparation | in-progress | on-hold | completed | entered-in-error | stopped additional codes) (Extension Type: code)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. MedicationDispense.medication[x]
      Definition

      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.

      ShortWhat medication was supplied
      Comments

      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.

      Control1..1
      BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.3.0
      (example to http://hl7.org/fhir/ValueSet/medication-codes|4.3.0)

      A coded concept identifying which substance or product can be dispensed.

      TypeChoice of: CodeableConcept, Reference(Medication)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. MedicationDispense.medication[x].extension:alternateReference
      Slice NamealternateReference
      Definition

      STU3: MedicationDispense.medication[x] additional types from child elements (display, identifier, reference)

      ShortSTU3: medication additional types
      Comments

      Element MedicationDispense.medication[x] is mapped to FHIR R4B element MedicationDispense.medication[x] as SourceIsBroaderThanTarget. The mappings for MedicationDispense.medication[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.medication[x] with unmapped reference targets: Medication. Source element MedicationDispense.medication[x] has unmapped reference types. While the target element MedicationDispense.medication[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. 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. .

      Control0..1
      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

      Guidance on how to interpret the contents of this table can be foundhere

      0. MedicationDispense
      2. MedicationDispense.meta
      4. MedicationDispense.meta.extension
      Control0..*
      SlicingThis element introduces a set of slices on MedicationDispense.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. MedicationDispense.meta.extension:meta
        Slice Namemeta
        Definition

        STU3: MedicationDispense.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

        ShortSTU3: meta additional types
        Comments

        Element MedicationDispense.meta is mapped to FHIR R4B element MedicationDispense.meta as SourceIsBroaderThanTarget. The mappings for MedicationDispense.meta do not cover the following types: Meta. The mappings for MedicationDispense.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

        Control0..1
        TypeExtension(STU3: meta additional types) (Complex Extension)
        8. MedicationDispense.text
        10. MedicationDispense.text.extension
        Control0..*
        SlicingThis element introduces a set of slices on MedicationDispense.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 12. MedicationDispense.text.extension:text
          Slice Nametext
          Definition

          STU3: MedicationDispense.text additional types (Narrative) additional types from child elements (div, status)

          ShortSTU3: text additional types
          Comments

          Element MedicationDispense.text is mapped to FHIR R4B element MedicationDispense.text as SourceIsBroaderThanTarget. The mappings for MedicationDispense.text do not cover the following types: Narrative. The mappings for MedicationDispense.text do not cover the following types based on type expansion: div, status. 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 "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

          Control0..1
          TypeExtension(STU3: text additional types) (Complex Extension)
          14. MedicationDispense.extension
          Control0..*
          SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. MedicationDispense.extension:notDone
            Slice NamenotDone
            Definition

            STU3: MedicationDispense.notDone (new:boolean)

            ShortSTU3: Whether the dispense was or was not performed (new)
            Comments

            Element MedicationDispense.notDone has a context of MedicationDispense based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.notDone has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

            Control0..1
            TypeExtension(STU3: Whether the dispense was or was not performed (new)) (Extension Type: boolean)
            18. MedicationDispense.identifier
            NoteThis is a business identifier, not a resource identifier (see discussion)
            20. MedicationDispense.identifier.extension
            Control0..*
            SlicingThis element introduces a set of slices on MedicationDispense.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 22. MedicationDispense.identifier.extension:identifier
              Slice Nameidentifier
              Definition

              STU3: MedicationDispense.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

              ShortSTU3: identifier additional types
              Comments

              Element MedicationDispense.identifier is mapped to FHIR R4B element MedicationDispense.identifier as SourceIsBroaderThanTarget. The mappings for MedicationDispense.identifier do not cover the following types: Identifier. The mappings for MedicationDispense.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value.

              Control0..*
              TypeExtension(STU3: identifier additional types) (Extension Type: Identifier)
              24. MedicationDispense.partOf
              26. MedicationDispense.partOf.extension
              Control0..*
              SlicingThis element introduces a set of slices on MedicationDispense.partOf.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 28. MedicationDispense.partOf.extension:partOf
                Slice NamepartOf
                Definition

                STU3: MedicationDispense.partOf additional types from child elements (display, identifier, reference)

                ShortSTU3: partOf additional types
                Comments

                Element MedicationDispense.partOf is mapped to FHIR R4B element MedicationDispense.partOf as SourceIsBroaderThanTarget. The mappings for MedicationDispense.partOf do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.partOf with unmapped reference targets: Procedure.

                Control0..*
                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                30. MedicationDispense.status
                32. MedicationDispense.status.extension
                Control0..*
                SlicingThis element introduces a set of slices on MedicationDispense.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 34. MedicationDispense.status.extension:status
                  Slice Namestatus
                  Definition

                  STU3: MedicationDispense.status additional codes

                  ShortSTU3: preparation | in-progress | on-hold | completed | entered-in-error | stopped additional codes
                  Comments

                  Element MedicationDispense.status is mapped to FHIR R4B element MedicationDispense.status as RelatedTo. The mappings for MedicationDispense.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationDispense.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                  Control0..1
                  TypeExtension(STU3: preparation | in-progress | on-hold | completed | entered-in-error | stopped additional codes) (Extension Type: code)
                  36. MedicationDispense.statusReasonReference
                  38. MedicationDispense.statusReasonReference.extension
                  Control0..*
                  SlicingThis element introduces a set of slices on MedicationDispense.statusReasonReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 40. MedicationDispense.statusReasonReference.extension:alternateReference
                    Slice NamealternateReference
                    Definition

                    STU3: MedicationDispense.notDoneReason[x] additional types from child elements (display, identifier, reference)

                    ShortSTU3: notDoneReason additional types
                    Comments

                    Element MedicationDispense.notDoneReason[x] is mapped to FHIR R4B element MedicationDispense.statusReason[x] as RelatedTo. The mappings for MedicationDispense.notDoneReason[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.notDoneReason[x] with unmapped reference targets: DetectedIssue. Source element MedicationDispense.notDoneReason[x] has unmapped reference types. While the target element MedicationDispense.statusReason[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it.

                    TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                    42. MedicationDispense.medicationReference
                    44. MedicationDispense.medicationReference.extension
                    Control0..*
                    SlicingThis element introduces a set of slices on MedicationDispense.medicationReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 46. MedicationDispense.medicationReference.extension:alternateReference
                      Slice NamealternateReference
                      Definition

                      STU3: MedicationDispense.medication[x] additional types from child elements (display, identifier, reference)

                      ShortSTU3: medication additional types
                      Comments

                      Element MedicationDispense.medication[x] is mapped to FHIR R4B element MedicationDispense.medication[x] as SourceIsBroaderThanTarget. The mappings for MedicationDispense.medication[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.medication[x] with unmapped reference targets: Medication. Source element MedicationDispense.medication[x] has unmapped reference types. While the target element MedicationDispense.medication[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. 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. .

                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                      48. MedicationDispense.subject
                      50. MedicationDispense.subject.extension
                      Control0..*
                      SlicingThis element introduces a set of slices on MedicationDispense.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 52. MedicationDispense.subject.extension:subject
                        Slice Namesubject
                        Definition

                        STU3: MedicationDispense.subject additional types from child elements (display, identifier, reference)

                        ShortSTU3: subject additional types
                        Comments

                        Element MedicationDispense.subject is mapped to FHIR R4B element MedicationDispense.subject as SourceIsBroaderThanTarget. The mappings for MedicationDispense.subject do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.subject with unmapped reference targets: Group, Patient. SubstanceAdministration->subject->Patient.

                        Control0..1
                        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                        54. MedicationDispense.context
                        56. MedicationDispense.context.extension
                        Control0..*
                        SlicingThis element introduces a set of slices on MedicationDispense.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 58. MedicationDispense.context.extension:context
                          Slice Namecontext
                          Definition

                          STU3: MedicationDispense.context additional types from child elements (display, identifier, reference)

                          ShortSTU3: context additional types
                          Comments

                          Element MedicationDispense.context is mapped to FHIR R4B element MedicationDispense.context as SourceIsBroaderThanTarget. The mappings for MedicationDispense.context do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.context with unmapped reference targets: Encounter, EpisodeOfCare.

                          Control0..1
                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                          60. MedicationDispense.supportingInformation
                          62. MedicationDispense.supportingInformation.extension
                          Control0..*
                          SlicingThis element introduces a set of slices on MedicationDispense.supportingInformation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 64. MedicationDispense.supportingInformation.extension:supportingInformation
                            Slice NamesupportingInformation
                            Definition

                            STU3: MedicationDispense.supportingInformation additional types from child elements (display, identifier, reference)

                            ShortSTU3: supportingInformation additional types
                            Comments

                            Element MedicationDispense.supportingInformation is mapped to FHIR R4B element MedicationDispense.supportingInformation as SourceIsBroaderThanTarget. The mappings for MedicationDispense.supportingInformation do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.supportingInformation with unmapped reference targets: Resource.

                            Control0..*
                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                            66. MedicationDispense.performer
                            68. MedicationDispense.performer.extension
                            Control0..*
                            SlicingThis element introduces a set of slices on MedicationDispense.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 70. MedicationDispense.performer.extension:onBehalfOf
                              Slice NameonBehalfOf
                              Definition

                              STU3: MedicationDispense.performer.onBehalfOf (new:Reference(Organization))

                              ShortSTU3: Organization organization was acting for (new)
                              Comments

                              Element MedicationDispense.performer.onBehalfOf has a context of MedicationDispense.performer based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.performer.onBehalfOf has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

                              Control0..1
                              TypeExtension(STU3: Organization organization was acting for (new)) (Extension Type: Reference(Cross-version Profile for STU3.Organization for use in FHIR R4B, Organization))
                              72. MedicationDispense.performer.actor
                              74. MedicationDispense.performer.actor.extension
                              Control0..*
                              SlicingThis element introduces a set of slices on MedicationDispense.performer.actor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 76. MedicationDispense.performer.actor.extension:actor
                                Slice Nameactor
                                Definition

                                STU3: MedicationDispense.performer.actor

                                ShortSTU3: actor
                                Comments

                                Element MedicationDispense.performer.actor is mapped to FHIR R4B element MedicationDispense.performer.actor as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.performer.actor with unmapped reference targets: Device, Organization, Patient, Practitioner, RelatedPerson.

                                Control0..1
                                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                78. MedicationDispense.authorizingPrescription
                                80. MedicationDispense.authorizingPrescription.extension
                                Control0..*
                                SlicingThis element introduces a set of slices on MedicationDispense.authorizingPrescription.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 82. MedicationDispense.authorizingPrescription.extension:authorizingPrescription
                                  Slice NameauthorizingPrescription
                                  Definition

                                  STU3: MedicationDispense.authorizingPrescription additional types from child elements (display, identifier, reference)

                                  ShortSTU3: authorizingPrescription additional types
                                  Comments

                                  Element MedicationDispense.authorizingPrescription is mapped to FHIR R4B element MedicationDispense.authorizingPrescription as SourceIsBroaderThanTarget. The mappings for MedicationDispense.authorizingPrescription do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.authorizingPrescription with unmapped reference targets: MedicationRequest. Maps to basedOn in Event logical model.

                                  Control0..*
                                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                  84. MedicationDispense.destination
                                  86. MedicationDispense.destination.extension
                                  Control0..*
                                  SlicingThis element introduces a set of slices on MedicationDispense.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 88. MedicationDispense.destination.extension:destination
                                    Slice Namedestination
                                    Definition

                                    STU3: MedicationDispense.destination additional types from child elements (display, identifier, reference)

                                    ShortSTU3: destination additional types
                                    Comments

                                    Element MedicationDispense.destination is mapped to FHIR R4B element MedicationDispense.destination as SourceIsBroaderThanTarget. The mappings for MedicationDispense.destination do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.destination with unmapped reference targets: Location.

                                    Control0..1
                                    TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                    90. MedicationDispense.receiver
                                    92. MedicationDispense.receiver.extension
                                    Control0..*
                                    SlicingThis element introduces a set of slices on MedicationDispense.receiver.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 94. MedicationDispense.receiver.extension:receiver
                                      Slice Namereceiver
                                      Definition

                                      STU3: MedicationDispense.receiver additional types from child elements (display, identifier, reference)

                                      ShortSTU3: receiver additional types
                                      Comments

                                      Element MedicationDispense.receiver is mapped to FHIR R4B element MedicationDispense.receiver as SourceIsBroaderThanTarget. The mappings for MedicationDispense.receiver do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.receiver with unmapped reference targets: Patient, Practitioner.

                                      Control0..*
                                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                      96. MedicationDispense.note
                                      98. MedicationDispense.note.extension
                                      Control0..*
                                      SlicingThis element introduces a set of slices on MedicationDispense.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 100. MedicationDispense.note.extension:note
                                        Slice Namenote
                                        Definition

                                        STU3: MedicationDispense.note additional types (Annotation) additional types from child elements (author[x], text, time)

                                        ShortSTU3: note additional types
                                        Comments

                                        Element MedicationDispense.note is mapped to FHIR R4B element MedicationDispense.note as SourceIsBroaderThanTarget. The mappings for MedicationDispense.note do not cover the following types: Annotation. The mappings for MedicationDispense.note do not cover the following types based on type expansion: author[x], text, time.

                                        Control0..*
                                        TypeExtension(STU3: note additional types) (Extension Type: Annotation)
                                        102. MedicationDispense.dosageInstruction
                                        104. MedicationDispense.dosageInstruction.extension
                                        Control0..*
                                        SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 106. MedicationDispense.dosageInstruction.extension:dosageInstruction
                                          Slice NamedosageInstruction
                                          Definition

                                          STU3: MedicationDispense.dosageInstruction additional types (Dosage) additional types from child elements (additionalInstruction, asNeeded[x], dose[x], maxDosePerAdministration, maxDosePerLifetime, maxDosePerPeriod, method, patientInstruction, rate[x], route, sequence, site, text, timing)

                                          ShortSTU3: dosageInstruction additional types
                                          Comments

                                          Element MedicationDispense.dosageInstruction is mapped to FHIR R4B element MedicationDispense.dosageInstruction as SourceIsBroaderThanTarget. The mappings for MedicationDispense.dosageInstruction do not cover the following types: Dosage. The mappings for MedicationDispense.dosageInstruction do not cover the following types based on type expansion: additionalInstruction, asNeeded[x], dose[x], maxDosePerAdministration, maxDosePerLifetime, maxDosePerPeriod, method, patientInstruction, rate[x], route, sequence, site, text, timing. 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.

                                          Control0..*
                                          TypeExtension(STU3: dosageInstruction additional types) (Extension Type: Dosage)
                                          108. MedicationDispense.substitution
                                          110. MedicationDispense.substitution.responsibleParty
                                          112. MedicationDispense.substitution.responsibleParty.extension
                                          Control0..*
                                          SlicingThis element introduces a set of slices on MedicationDispense.substitution.responsibleParty.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 114. MedicationDispense.substitution.responsibleParty.extension:responsibleParty
                                            Slice NameresponsibleParty
                                            Definition

                                            STU3: MedicationDispense.substitution.responsibleParty additional types from child elements (display, identifier, reference)

                                            ShortSTU3: responsibleParty additional types
                                            Comments

                                            Element MedicationDispense.substitution.responsibleParty is mapped to FHIR R4B element MedicationDispense.substitution.responsibleParty as SourceIsBroaderThanTarget. The mappings for MedicationDispense.substitution.responsibleParty do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.substitution.responsibleParty with unmapped reference targets: Practitioner.

                                            Control0..*
                                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                            116. MedicationDispense.detectedIssue
                                            118. MedicationDispense.detectedIssue.extension
                                            Control0..*
                                            SlicingThis element introduces a set of slices on MedicationDispense.detectedIssue.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 120. MedicationDispense.detectedIssue.extension:detectedIssue
                                              Slice NamedetectedIssue
                                              Definition

                                              STU3: MedicationDispense.detectedIssue additional types from child elements (display, identifier, reference)

                                              ShortSTU3: detectedIssue additional types
                                              Comments

                                              Element MedicationDispense.detectedIssue is mapped to FHIR R4B element MedicationDispense.detectedIssue as SourceIsBroaderThanTarget. The mappings for MedicationDispense.detectedIssue do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.detectedIssue with unmapped reference targets: DetectedIssue.

                                              Control0..*
                                              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                              122. MedicationDispense.eventHistory
                                              124. MedicationDispense.eventHistory.extension
                                              Control0..*
                                              SlicingThis element introduces a set of slices on MedicationDispense.eventHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 126. MedicationDispense.eventHistory.extension:eventHistory
                                                Slice NameeventHistory
                                                Definition

                                                STU3: MedicationDispense.eventHistory additional types from child elements (display, identifier, reference)

                                                ShortSTU3: A list of releveant lifecycle events additional types
                                                Comments

                                                Element MedicationDispense.eventHistory is mapped to FHIR R4B element MedicationDispense.eventHistory as SourceIsBroaderThanTarget. The mappings for MedicationDispense.eventHistory do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.eventHistory with unmapped reference targets: Provenance. 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.).

                                                Control0..*
                                                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))

                                                Guidance on how to interpret the contents of this table can be foundhere

                                                0. MedicationDispense
                                                Definition

                                                Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

                                                ShortDispensing a medication to a named patient
                                                Control0..*
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
                                                dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
                                                2. MedicationDispense.id
                                                Definition

                                                The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                ShortLogical id of this artifact
                                                Comments

                                                The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                Control0..1
                                                Typeid
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summarytrue
                                                4. MedicationDispense.meta
                                                Definition

                                                The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                ShortMetadata about the resource
                                                Control0..1
                                                TypeMeta
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                6. MedicationDispense.meta.id
                                                Definition

                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                8. MedicationDispense.meta.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on MedicationDispense.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 10. MedicationDispense.meta.extension:meta
                                                  Slice Namemeta
                                                  Definition

                                                  STU3: MedicationDispense.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

                                                  ShortSTU3: meta additional types
                                                  Comments

                                                  Element MedicationDispense.meta is mapped to FHIR R4B element MedicationDispense.meta as SourceIsBroaderThanTarget. The mappings for MedicationDispense.meta do not cover the following types: Meta. The mappings for MedicationDispense.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

                                                  Control0..1
                                                  TypeExtension(STU3: meta additional types) (Complex Extension)
                                                  Is Modifierfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  12. MedicationDispense.meta.versionId
                                                  Definition

                                                  The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                                                  ShortVersion specific identifier
                                                  Comments

                                                  The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                                                  Control0..1
                                                  Typeid
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  14. MedicationDispense.meta.lastUpdated
                                                  Definition

                                                  When the resource last changed - e.g. when the version changed.

                                                  ShortWhen the resource version last changed
                                                  Comments

                                                  This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                                                  Control0..1
                                                  Typeinstant
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  16. MedicationDispense.meta.source
                                                  Definition

                                                  A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                                                  ShortIdentifies where the resource comes from
                                                  Comments

                                                  In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                                                  This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                                                  Control0..1
                                                  Typeuri
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  18. MedicationDispense.meta.profile
                                                  Definition

                                                  A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                                                  ShortProfiles this resource claims to conform to
                                                  Comments

                                                  It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                                                  Control0..*
                                                  Typecanonical(StructureDefinition)
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  20. MedicationDispense.meta.security
                                                  Definition

                                                  Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                                                  ShortSecurity Labels applied to this resource
                                                  Comments

                                                  The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                                                  Control0..*
                                                  BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                                                  (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.3.0)
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  22. MedicationDispense.meta.tag
                                                  Definition

                                                  Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                                                  ShortTags applied to this resource
                                                  Comments

                                                  The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                                                  Control0..*
                                                  BindingFor example codes, see CommonTags
                                                  (example to http://hl7.org/fhir/ValueSet/common-tags|4.3.0)
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  24. MedicationDispense.implicitRules
                                                  Definition

                                                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                  ShortA set of rules under which this content was created
                                                  Comments

                                                  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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                  Control0..1
                                                  Typeuri
                                                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  26. MedicationDispense.language
                                                  Definition

                                                  The base language in which the resource is written.

                                                  ShortLanguage of the resource content
                                                  Comments

                                                  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).

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from CommonLanguages
                                                  (preferred to http://hl7.org/fhir/ValueSet/languages|4.3.0)

                                                  IETF language tag

                                                  Additional BindingsPurpose
                                                  AllLanguagesMax Binding
                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  28. MedicationDispense.text
                                                  Definition

                                                  A human-readable narrative that contains a summary of the resource and can 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                  ShortText summary of the resource, for human interpretation
                                                  Comments

                                                  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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                  Control0..1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Alternate Namesnarrative, html, xhtml, display
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  30. MedicationDispense.text.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typeid
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  32. MedicationDispense.text.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on MedicationDispense.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 34. MedicationDispense.text.extension:text
                                                    Slice Nametext
                                                    Definition

                                                    STU3: MedicationDispense.text additional types (Narrative) additional types from child elements (div, status)

                                                    ShortSTU3: text additional types
                                                    Comments

                                                    Element MedicationDispense.text is mapped to FHIR R4B element MedicationDispense.text as SourceIsBroaderThanTarget. The mappings for MedicationDispense.text do not cover the following types: Narrative. The mappings for MedicationDispense.text do not cover the following types based on type expansion: div, status. 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 "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

                                                    Control0..1
                                                    TypeExtension(STU3: text additional types) (Complex Extension)
                                                    Is Modifierfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    36. MedicationDispense.text.status
                                                    Definition

                                                    The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

                                                    Shortgenerated | extensions | additional | empty
                                                    Control1..1
                                                    BindingThe codes SHALL be taken from NarrativeStatus
                                                    (required to http://hl7.org/fhir/ValueSet/narrative-status|4.3.0)
                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    38. MedicationDispense.text.div
                                                    Definition

                                                    The actual narrative content, a stripped down version of XHTML.

                                                    ShortLimited xhtml content
                                                    Comments

                                                    The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

                                                    Control1..1
                                                    Typexhtml
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
                                                    txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
                                                    40. MedicationDispense.contained
                                                    Definition

                                                    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.

                                                    ShortContained, inline Resources
                                                    Comments

                                                    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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                    Control0..*
                                                    TypeResource
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Alternate Namesinline resources, anonymous resources, contained resources
                                                    Invariantsdom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
                                                    42. MedicationDispense.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 44. MedicationDispense.extension:notDone
                                                      Slice NamenotDone
                                                      Definition

                                                      STU3: MedicationDispense.notDone (new:boolean)

                                                      ShortSTU3: Whether the dispense was or was not performed (new)
                                                      Comments

                                                      Element MedicationDispense.notDone has a context of MedicationDispense based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.notDone has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(STU3: Whether the dispense was or was not performed (new)) (Extension Type: boolean)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      46. MedicationDispense.modifierExtension
                                                      Definition

                                                      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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored
                                                      Comments

                                                      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.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      48. MedicationDispense.identifier
                                                      Definition

                                                      Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                                                      ShortExternal identifier
                                                      Comments

                                                      This is a business identifier, not a resource identifier.

                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      50. MedicationDispense.identifier.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typeid
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      52. MedicationDispense.identifier.extension
                                                      Definition

                                                      An Extension

                                                      ShortExtension
                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on MedicationDispense.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 54. MedicationDispense.identifier.extension:identifier
                                                        Slice Nameidentifier
                                                        Definition

                                                        STU3: MedicationDispense.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

                                                        ShortSTU3: identifier additional types
                                                        Comments

                                                        Element MedicationDispense.identifier is mapped to FHIR R4B element MedicationDispense.identifier as SourceIsBroaderThanTarget. The mappings for MedicationDispense.identifier do not cover the following types: Identifier. The mappings for MedicationDispense.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value.

                                                        Control0..*
                                                        TypeExtension(STU3: identifier additional types) (Extension Type: Identifier)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        56. MedicationDispense.identifier.use
                                                        Definition

                                                        The purpose of this identifier.

                                                        Shortusual | official | temp | secondary | old (If known)
                                                        Comments

                                                        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                        Control0..1
                                                        BindingThe codes SHALL be taken from IdentifierUse
                                                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                                        Typecode
                                                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        58. MedicationDispense.identifier.type
                                                        Definition

                                                        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                        ShortDescription of identifier
                                                        Comments

                                                        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                        Control0..1
                                                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Requirements

                                                        Allows users to make use of identifiers when the identifier system is not known.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        60. MedicationDispense.identifier.system
                                                        Definition

                                                        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                        ShortThe namespace for the identifier value
                                                        Comments

                                                        Identifier.system is always case sensitive.

                                                        Control0..1
                                                        Typeuri
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                        ExampleGeneral: http://www.acme.com/identifiers/patient
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        62. MedicationDispense.identifier.value
                                                        Definition

                                                        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                        ShortThe value that is unique
                                                        Comments

                                                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        ExampleGeneral: 123456
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        64. MedicationDispense.identifier.period
                                                        Definition

                                                        Time period during which identifier is/was valid for use.

                                                        ShortTime period when id is/was valid for use
                                                        Control0..1
                                                        TypePeriod
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        66. MedicationDispense.identifier.assigner
                                                        Definition

                                                        Organization that issued/manages the identifier.

                                                        ShortOrganization that issued id (may be just text)
                                                        Comments

                                                        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                        Control0..1
                                                        TypeReference(Organization)
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        68. MedicationDispense.partOf
                                                        Definition

                                                        The procedure that trigger the dispense.

                                                        ShortEvent that dispense is part of
                                                        Control0..*
                                                        TypeReference(Procedure)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        70. MedicationDispense.partOf.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typeid
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        72. MedicationDispense.partOf.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on MedicationDispense.partOf.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 74. MedicationDispense.partOf.extension:partOf
                                                          Slice NamepartOf
                                                          Definition

                                                          STU3: MedicationDispense.partOf additional types from child elements (display, identifier, reference)

                                                          ShortSTU3: partOf additional types
                                                          Comments

                                                          Element MedicationDispense.partOf is mapped to FHIR R4B element MedicationDispense.partOf as SourceIsBroaderThanTarget. The mappings for MedicationDispense.partOf do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.partOf with unmapped reference targets: Procedure.

                                                          Control0..1
                                                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          76. MedicationDispense.partOf.reference
                                                          Definition

                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                          Comments

                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                          Control0..1
                                                          This element is affected by the following invariants: ref-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          78. MedicationDispense.partOf.type
                                                          Definition

                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                          ShortType the reference refers to (e.g. "Patient")
                                                          Comments

                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                          Control0..1
                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                          Typeuri
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          80. MedicationDispense.partOf.identifier
                                                          Definition

                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                          ShortLogical reference, when literal reference is not known
                                                          Comments

                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                          Control0..1
                                                          TypeIdentifier
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          82. MedicationDispense.partOf.display
                                                          Definition

                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                          ShortText alternative for the resource
                                                          Comments

                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          84. MedicationDispense.status
                                                          Definition

                                                          A code specifying the state of the set of dispense events.

                                                          Shortpreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
                                                          Comments

                                                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                          Control1..1
                                                          BindingThe codes SHALL be taken from MedicationDispense Status Codes
                                                          (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.3.0)

                                                          Describes the lifecycle of the dispense.

                                                          Typecode
                                                          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          86. MedicationDispense.status.id
                                                          Definition

                                                          unique id for the element within a resource (for internal references)

                                                          Shortxml:id (or equivalent in JSON)
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          88. MedicationDispense.status.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on MedicationDispense.status.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 90. MedicationDispense.status.extension:status
                                                            Slice Namestatus
                                                            Definition

                                                            STU3: MedicationDispense.status additional codes

                                                            ShortSTU3: preparation | in-progress | on-hold | completed | entered-in-error | stopped additional codes
                                                            Comments

                                                            Element MedicationDispense.status is mapped to FHIR R4B element MedicationDispense.status as RelatedTo. The mappings for MedicationDispense.status do not allow expression of the necessary codes, per the bindings on the source and target. The target context MedicationDispense.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(STU3: preparation | in-progress | on-hold | completed | entered-in-error | stopped additional codes) (Extension Type: code)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            92. MedicationDispense.status.value
                                                            Definition

                                                            Primitive value for code

                                                            ShortPrimitive value for code
                                                            Control0..1
                                                            Typecode
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            94. MedicationDispense.statusReason[x]
                                                            Definition

                                                            Indicates the reason why a dispense was not performed.

                                                            ShortWhy a dispense was not performed
                                                            Control0..1
                                                            BindingFor example codes, see MedicationDispense Status Reason Codes
                                                            (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.3.0)

                                                            A code describing why a dispense was not performed.

                                                            TypeChoice of: CodeableConcept, Reference(DetectedIssue)
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            96. MedicationDispense.statusReason[x].id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typeid
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            98. MedicationDispense.statusReason[x].extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 100. MedicationDispense.statusReason[x].extension:alternateReference
                                                              Slice NamealternateReference
                                                              Definition

                                                              STU3: MedicationDispense.notDoneReason[x] additional types from child elements (display, identifier, reference)

                                                              ShortSTU3: notDoneReason additional types
                                                              Comments

                                                              Element MedicationDispense.notDoneReason[x] is mapped to FHIR R4B element MedicationDispense.statusReason[x] as RelatedTo. The mappings for MedicationDispense.notDoneReason[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.notDoneReason[x] with unmapped reference targets: DetectedIssue. Source element MedicationDispense.notDoneReason[x] has unmapped reference types. While the target element MedicationDispense.statusReason[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it.

                                                              Control0..1
                                                              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              102. MedicationDispense.category
                                                              Definition

                                                              Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

                                                              ShortType of medication dispense
                                                              Comments

                                                              The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.

                                                              Control0..1
                                                              BindingThe codes SHOULD be taken from MedicationDispense Category Codes
                                                              (preferred to http://hl7.org/fhir/ValueSet/medicationdispense-category|4.3.0)

                                                              A code describing where the dispensed medication is expected to be consumed or administered.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              104. MedicationDispense.medication[x]
                                                              Definition

                                                              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.

                                                              ShortWhat medication was supplied
                                                              Comments

                                                              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.

                                                              Control1..1
                                                              BindingFor example codes, see SNOMEDCTMedicationCodes
                                                              (example to http://hl7.org/fhir/ValueSet/medication-codes|4.3.0)

                                                              A coded concept identifying which substance or product can be dispensed.

                                                              TypeChoice of: CodeableConcept, Reference(Medication)
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summarytrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              106. MedicationDispense.medication[x].id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typeid
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              108. MedicationDispense.medication[x].extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on MedicationDispense.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 110. MedicationDispense.medication[x].extension:alternateReference
                                                                Slice NamealternateReference
                                                                Definition

                                                                STU3: MedicationDispense.medication[x] additional types from child elements (display, identifier, reference)

                                                                ShortSTU3: medication additional types
                                                                Comments

                                                                Element MedicationDispense.medication[x] is mapped to FHIR R4B element MedicationDispense.medication[x] as SourceIsBroaderThanTarget. The mappings for MedicationDispense.medication[x] do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.medication[x] with unmapped reference targets: Medication. Source element MedicationDispense.medication[x] has unmapped reference types. While the target element MedicationDispense.medication[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. 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. .

                                                                Control0..1
                                                                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                112. MedicationDispense.subject
                                                                Definition

                                                                A link to a resource representing the person or the group to whom the medication will be given.

                                                                ShortWho the dispense is for
                                                                Comments

                                                                SubstanceAdministration->subject->Patient.

                                                                Control0..1
                                                                TypeReference(Patient, Group)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                114. MedicationDispense.subject.id
                                                                Definition

                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typeid
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                116. MedicationDispense.subject.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on MedicationDispense.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 118. MedicationDispense.subject.extension:subject
                                                                  Slice Namesubject
                                                                  Definition

                                                                  STU3: MedicationDispense.subject additional types from child elements (display, identifier, reference)

                                                                  ShortSTU3: subject additional types
                                                                  Comments

                                                                  Element MedicationDispense.subject is mapped to FHIR R4B element MedicationDispense.subject as SourceIsBroaderThanTarget. The mappings for MedicationDispense.subject do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.subject with unmapped reference targets: Group, Patient. SubstanceAdministration->subject->Patient.

                                                                  Control0..1
                                                                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  120. MedicationDispense.subject.reference
                                                                  Definition

                                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                                  Comments

                                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ref-1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  122. MedicationDispense.subject.type
                                                                  Definition

                                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                  ShortType the reference refers to (e.g. "Patient")
                                                                  Comments

                                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                  Control0..1
                                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                  Typeuri
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  124. MedicationDispense.subject.identifier
                                                                  Definition

                                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                  ShortLogical reference, when literal reference is not known
                                                                  Comments

                                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                  Control0..1
                                                                  TypeIdentifier
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  126. MedicationDispense.subject.display
                                                                  Definition

                                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                                  ShortText alternative for the resource
                                                                  Comments

                                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  128. MedicationDispense.context
                                                                  Definition

                                                                  The encounter or episode of care that establishes the context for this event.

                                                                  ShortEncounter / Episode associated with event
                                                                  Control0..1
                                                                  TypeReference(Encounter, EpisodeOfCare)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  130. MedicationDispense.context.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typeid
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  132. MedicationDispense.context.extension
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on MedicationDispense.context.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 134. MedicationDispense.context.extension:context
                                                                    Slice Namecontext
                                                                    Definition

                                                                    STU3: MedicationDispense.context additional types from child elements (display, identifier, reference)

                                                                    ShortSTU3: context additional types
                                                                    Comments

                                                                    Element MedicationDispense.context is mapped to FHIR R4B element MedicationDispense.context as SourceIsBroaderThanTarget. The mappings for MedicationDispense.context do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.context with unmapped reference targets: Encounter, EpisodeOfCare.

                                                                    Control0..1
                                                                    TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    136. MedicationDispense.context.reference
                                                                    Definition

                                                                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                    ShortLiteral reference, Relative, internal or absolute URL
                                                                    Comments

                                                                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ref-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    138. MedicationDispense.context.type
                                                                    Definition

                                                                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                    ShortType the reference refers to (e.g. "Patient")
                                                                    Comments

                                                                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                    Control0..1
                                                                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                    (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                    Typeuri
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    140. MedicationDispense.context.identifier
                                                                    Definition

                                                                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                    ShortLogical reference, when literal reference is not known
                                                                    Comments

                                                                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                    Control0..1
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    142. MedicationDispense.context.display
                                                                    Definition

                                                                    Plain text narrative that identifies the resource in addition to the resource reference.

                                                                    ShortText alternative for the resource
                                                                    Comments

                                                                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    144. MedicationDispense.supportingInformation
                                                                    Definition

                                                                    Additional information that supports the medication being dispensed.

                                                                    ShortInformation that supports the dispensing of the medication
                                                                    Control0..*
                                                                    TypeReference(Resource)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    146. MedicationDispense.supportingInformation.id
                                                                    Definition

                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typeid
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    148. MedicationDispense.supportingInformation.extension
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    SlicingThis element introduces a set of slices on MedicationDispense.supportingInformation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 150. MedicationDispense.supportingInformation.extension:supportingInformation
                                                                      Slice NamesupportingInformation
                                                                      Definition

                                                                      STU3: MedicationDispense.supportingInformation additional types from child elements (display, identifier, reference)

                                                                      ShortSTU3: supportingInformation additional types
                                                                      Comments

                                                                      Element MedicationDispense.supportingInformation is mapped to FHIR R4B element MedicationDispense.supportingInformation as SourceIsBroaderThanTarget. The mappings for MedicationDispense.supportingInformation do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.supportingInformation with unmapped reference targets: Resource.

                                                                      Control0..1
                                                                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      152. MedicationDispense.supportingInformation.reference
                                                                      Definition

                                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                      Comments

                                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ref-1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      154. MedicationDispense.supportingInformation.type
                                                                      Definition

                                                                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                      ShortType the reference refers to (e.g. "Patient")
                                                                      Comments

                                                                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                      Control0..1
                                                                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                      (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                      Typeuri
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      156. MedicationDispense.supportingInformation.identifier
                                                                      Definition

                                                                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                      ShortLogical reference, when literal reference is not known
                                                                      Comments

                                                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                      Control0..1
                                                                      TypeIdentifier
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      158. MedicationDispense.supportingInformation.display
                                                                      Definition

                                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                                      ShortText alternative for the resource
                                                                      Comments

                                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      160. MedicationDispense.performer
                                                                      Definition

                                                                      Indicates who or what performed the event.

                                                                      ShortWho performed event
                                                                      Control0..*
                                                                      TypeBackboneElement
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                      162. MedicationDispense.performer.id
                                                                      Definition

                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      164. MedicationDispense.performer.extension
                                                                      Definition

                                                                      An Extension

                                                                      ShortExtension
                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on MedicationDispense.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 166. MedicationDispense.performer.extension:onBehalfOf
                                                                        Slice NameonBehalfOf
                                                                        Definition

                                                                        STU3: MedicationDispense.performer.onBehalfOf (new:Reference(Organization))

                                                                        ShortSTU3: Organization organization was acting for (new)
                                                                        Comments

                                                                        Element MedicationDispense.performer.onBehalfOf has a context of MedicationDispense.performer based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.performer.onBehalfOf has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension(STU3: Organization organization was acting for (new)) (Extension Type: Reference(Cross-version Profile for STU3.Organization for use in FHIR R4B, Organization))
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        168. MedicationDispense.performer.modifierExtension
                                                                        Definition

                                                                        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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        170. MedicationDispense.performer.function
                                                                        Definition

                                                                        Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

                                                                        ShortWho performed the dispense and what they did
                                                                        Control0..1
                                                                        BindingFor example codes, see MedicationDispense Performer Function Codes
                                                                        (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function|4.3.0)

                                                                        A code describing the role an individual played in dispensing a medication.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows disambiguation of the types of involvement of different performers.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        172. MedicationDispense.performer.actor
                                                                        Definition

                                                                        The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

                                                                        ShortIndividual who was performing
                                                                        Control1..1
                                                                        TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        174. MedicationDispense.performer.actor.id
                                                                        Definition

                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typeid
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        176. MedicationDispense.performer.actor.extension
                                                                        Definition

                                                                        An Extension

                                                                        ShortExtension
                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on MedicationDispense.performer.actor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 178. MedicationDispense.performer.actor.extension:actor
                                                                          Slice Nameactor
                                                                          Definition

                                                                          STU3: MedicationDispense.performer.actor

                                                                          ShortSTU3: actor
                                                                          Comments

                                                                          Element MedicationDispense.performer.actor is mapped to FHIR R4B element MedicationDispense.performer.actor as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.performer.actor with unmapped reference targets: Device, Organization, Patient, Practitioner, RelatedPerson.

                                                                          Control0..1
                                                                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          180. MedicationDispense.performer.actor.reference
                                                                          Definition

                                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                          Comments

                                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ref-1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          182. MedicationDispense.performer.actor.type
                                                                          Definition

                                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                          ShortType the reference refers to (e.g. "Patient")
                                                                          Comments

                                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                          Control0..1
                                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                          Typeuri
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          184. MedicationDispense.performer.actor.identifier
                                                                          Definition

                                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                          ShortLogical reference, when literal reference is not known
                                                                          Comments

                                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                          Control0..1
                                                                          TypeIdentifier
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          186. MedicationDispense.performer.actor.display
                                                                          Definition

                                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                                          ShortText alternative for the resource
                                                                          Comments

                                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          188. MedicationDispense.location
                                                                          Definition

                                                                          The principal physical location where the dispense was performed.

                                                                          ShortWhere the dispense occurred
                                                                          Control0..1
                                                                          TypeReference(Location)
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          190. MedicationDispense.authorizingPrescription
                                                                          Definition

                                                                          Indicates the medication order that is being dispensed against.

                                                                          ShortMedication order that authorizes the dispense
                                                                          Comments

                                                                          Maps to basedOn in Event logical model.

                                                                          Control0..*
                                                                          TypeReference(MedicationRequest)
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          192. MedicationDispense.authorizingPrescription.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typeid
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          194. MedicationDispense.authorizingPrescription.extension
                                                                          Definition

                                                                          An Extension

                                                                          ShortExtension
                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on MedicationDispense.authorizingPrescription.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 196. MedicationDispense.authorizingPrescription.extension:authorizingPrescription
                                                                            Slice NameauthorizingPrescription
                                                                            Definition

                                                                            STU3: MedicationDispense.authorizingPrescription additional types from child elements (display, identifier, reference)

                                                                            ShortSTU3: authorizingPrescription additional types
                                                                            Comments

                                                                            Element MedicationDispense.authorizingPrescription is mapped to FHIR R4B element MedicationDispense.authorizingPrescription as SourceIsBroaderThanTarget. The mappings for MedicationDispense.authorizingPrescription do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.authorizingPrescription with unmapped reference targets: MedicationRequest. Maps to basedOn in Event logical model.

                                                                            Control0..1
                                                                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            198. MedicationDispense.authorizingPrescription.reference
                                                                            Definition

                                                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                                            Comments

                                                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ref-1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            200. MedicationDispense.authorizingPrescription.type
                                                                            Definition

                                                                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                            ShortType the reference refers to (e.g. "Patient")
                                                                            Comments

                                                                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                            Control0..1
                                                                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                            (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                            Typeuri
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            202. MedicationDispense.authorizingPrescription.identifier
                                                                            Definition

                                                                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                            ShortLogical reference, when literal reference is not known
                                                                            Comments

                                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                            Control0..1
                                                                            TypeIdentifier
                                                                            Is Modifierfalse
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            204. MedicationDispense.authorizingPrescription.display
                                                                            Definition

                                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                                            ShortText alternative for the resource
                                                                            Comments

                                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            206. MedicationDispense.type
                                                                            Definition

                                                                            Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                                                                            ShortTrial fill, partial fill, emergency fill, etc.
                                                                            Control0..1
                                                                            BindingFor example codes, see ActPharmacySupplyType (3.0.0)
                                                                            (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType|3.0.0)

                                                                            ActPharmacySupplyType

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            208. MedicationDispense.quantity
                                                                            Definition

                                                                            The amount of medication that has been dispensed. Includes unit of measure.

                                                                            ShortAmount dispensed
                                                                            Control0..1
                                                                            TypeQuantity(SimpleQuantity)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            210. MedicationDispense.daysSupply
                                                                            Definition

                                                                            The amount of medication expressed as a timing amount.

                                                                            ShortAmount of medication expressed as a timing amount
                                                                            Control0..1
                                                                            TypeQuantity(SimpleQuantity)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            212. MedicationDispense.whenPrepared
                                                                            Definition

                                                                            The time when the dispensed product was packaged and reviewed.

                                                                            ShortWhen product was packaged and reviewed
                                                                            Control0..1
                                                                            TypedateTime
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supportfalse
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            214. MedicationDispense.whenHandedOver
                                                                            Definition

                                                                            The time the dispensed product was provided to the patient or their representative.

                                                                            ShortWhen product was given out
                                                                            Control0..1
                                                                            TypedateTime
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            216. MedicationDispense.destination
                                                                            Definition

                                                                            Identification of the facility/location where the medication was shipped to, as part of the dispense event.

                                                                            ShortWhere the medication was sent
                                                                            Control0..1
                                                                            TypeReference(Location)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            218. MedicationDispense.destination.id
                                                                            Definition

                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typeid
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            220. MedicationDispense.destination.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on MedicationDispense.destination.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 222. MedicationDispense.destination.extension:destination
                                                                              Slice Namedestination
                                                                              Definition

                                                                              STU3: MedicationDispense.destination additional types from child elements (display, identifier, reference)

                                                                              ShortSTU3: destination additional types
                                                                              Comments

                                                                              Element MedicationDispense.destination is mapped to FHIR R4B element MedicationDispense.destination as SourceIsBroaderThanTarget. The mappings for MedicationDispense.destination do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.destination with unmapped reference targets: Location.

                                                                              Control0..1
                                                                              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              224. MedicationDispense.destination.reference
                                                                              Definition

                                                                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                              ShortLiteral reference, Relative, internal or absolute URL
                                                                              Comments

                                                                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ref-1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              226. MedicationDispense.destination.type
                                                                              Definition

                                                                              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                              ShortType the reference refers to (e.g. "Patient")
                                                                              Comments

                                                                              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                              Control0..1
                                                                              BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                              Typeuri
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              228. MedicationDispense.destination.identifier
                                                                              Definition

                                                                              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                              ShortLogical reference, when literal reference is not known
                                                                              Comments

                                                                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                              Control0..1
                                                                              TypeIdentifier
                                                                              Is Modifierfalse
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              230. MedicationDispense.destination.display
                                                                              Definition

                                                                              Plain text narrative that identifies the resource in addition to the resource reference.

                                                                              ShortText alternative for the resource
                                                                              Comments

                                                                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              232. MedicationDispense.receiver
                                                                              Definition

                                                                              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.

                                                                              ShortWho collected the medication
                                                                              Control0..*
                                                                              TypeReference(Patient, Practitioner)
                                                                              Is Modifierfalse
                                                                              Must Supportfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              234. MedicationDispense.receiver.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typeid
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              236. MedicationDispense.receiver.extension
                                                                              Definition

                                                                              An Extension

                                                                              ShortExtension
                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on MedicationDispense.receiver.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 238. MedicationDispense.receiver.extension:receiver
                                                                                Slice Namereceiver
                                                                                Definition

                                                                                STU3: MedicationDispense.receiver additional types from child elements (display, identifier, reference)

                                                                                ShortSTU3: receiver additional types
                                                                                Comments

                                                                                Element MedicationDispense.receiver is mapped to FHIR R4B element MedicationDispense.receiver as SourceIsBroaderThanTarget. The mappings for MedicationDispense.receiver do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.receiver with unmapped reference targets: Patient, Practitioner.

                                                                                Control0..1
                                                                                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                240. MedicationDispense.receiver.reference
                                                                                Definition

                                                                                A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                ShortLiteral reference, Relative, internal or absolute URL
                                                                                Comments

                                                                                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ref-1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                242. MedicationDispense.receiver.type
                                                                                Definition

                                                                                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                ShortType the reference refers to (e.g. "Patient")
                                                                                Comments

                                                                                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                Control0..1
                                                                                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                                Typeuri
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                244. MedicationDispense.receiver.identifier
                                                                                Definition

                                                                                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                ShortLogical reference, when literal reference is not known
                                                                                Comments

                                                                                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                Control0..1
                                                                                TypeIdentifier
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                246. MedicationDispense.receiver.display
                                                                                Definition

                                                                                Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                ShortText alternative for the resource
                                                                                Comments

                                                                                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                248. MedicationDispense.note
                                                                                Definition

                                                                                Extra information about the dispense that could not be conveyed in the other attributes.

                                                                                ShortInformation about the dispense
                                                                                Control0..*
                                                                                TypeAnnotation
                                                                                Is Modifierfalse
                                                                                Must Supportfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                250. MedicationDispense.note.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typeid
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                252. MedicationDispense.note.extension
                                                                                Definition

                                                                                An Extension

                                                                                ShortExtension
                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on MedicationDispense.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 254. MedicationDispense.note.extension:note
                                                                                  Slice Namenote
                                                                                  Definition

                                                                                  STU3: MedicationDispense.note additional types (Annotation) additional types from child elements (author[x], text, time)

                                                                                  ShortSTU3: note additional types
                                                                                  Comments

                                                                                  Element MedicationDispense.note is mapped to FHIR R4B element MedicationDispense.note as SourceIsBroaderThanTarget. The mappings for MedicationDispense.note do not cover the following types: Annotation. The mappings for MedicationDispense.note do not cover the following types based on type expansion: author[x], text, time.

                                                                                  Control0..*
                                                                                  TypeExtension(STU3: note additional types) (Extension Type: Annotation)
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  256. MedicationDispense.note.author[x]
                                                                                  Definition

                                                                                  The individual responsible for making the annotation.

                                                                                  ShortIndividual responsible for the annotation
                                                                                  Comments

                                                                                  Organization is used when there's no need for specific attribution as to who made the comment.

                                                                                  Control0..1
                                                                                  TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  258. MedicationDispense.note.time
                                                                                  Definition

                                                                                  Indicates when this particular annotation was made.

                                                                                  ShortWhen the annotation was made
                                                                                  Control0..1
                                                                                  TypedateTime
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  260. MedicationDispense.note.text
                                                                                  Definition

                                                                                  The text of the annotation in markdown format.

                                                                                  ShortThe annotation - text content (as markdown)
                                                                                  Control1..1
                                                                                  Typemarkdown
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  262. MedicationDispense.dosageInstruction
                                                                                  Definition

                                                                                  Indicates how the medication is to be used by the patient.

                                                                                  ShortHow the medication is to be used by the patient or administered by the caregiver
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..*
                                                                                  TypeDosage
                                                                                  Is Modifierfalse
                                                                                  Must Supportfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  264. MedicationDispense.dosageInstruction.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typeid
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  266. MedicationDispense.dosageInstruction.extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 268. MedicationDispense.dosageInstruction.extension:dosageInstruction
                                                                                    Slice NamedosageInstruction
                                                                                    Definition

                                                                                    STU3: MedicationDispense.dosageInstruction additional types (Dosage) additional types from child elements (additionalInstruction, asNeeded[x], dose[x], maxDosePerAdministration, maxDosePerLifetime, maxDosePerPeriod, method, patientInstruction, rate[x], route, sequence, site, text, timing)

                                                                                    ShortSTU3: dosageInstruction additional types
                                                                                    Comments

                                                                                    Element MedicationDispense.dosageInstruction is mapped to FHIR R4B element MedicationDispense.dosageInstruction as SourceIsBroaderThanTarget. The mappings for MedicationDispense.dosageInstruction do not cover the following types: Dosage. The mappings for MedicationDispense.dosageInstruction do not cover the following types based on type expansion: additionalInstruction, asNeeded[x], dose[x], maxDosePerAdministration, maxDosePerLifetime, maxDosePerPeriod, method, patientInstruction, rate[x], route, sequence, site, text, timing. 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.

                                                                                    Control0..*
                                                                                    TypeExtension(STU3: dosageInstruction additional types) (Extension Type: Dosage)
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    270. MedicationDispense.dosageInstruction.modifierExtension
                                                                                    Definition

                                                                                    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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    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.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    272. MedicationDispense.dosageInstruction.sequence
                                                                                    Definition

                                                                                    Indicates the order in which the dosage instructions should be applied or interpreted.

                                                                                    ShortThe order of the dosage instructions
                                                                                    Control0..1
                                                                                    Typeinteger
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    274. MedicationDispense.dosageInstruction.text
                                                                                    Definition

                                                                                    Free text dosage instructions e.g. SIG.

                                                                                    ShortFree text dosage instructions e.g. SIG
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    276. MedicationDispense.dosageInstruction.additionalInstruction
                                                                                    Definition

                                                                                    Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                                                                                    ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                                                                                    Comments

                                                                                    Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                                                                                    Control0..*
                                                                                    BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                                                                    (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.3.0)
                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    278. MedicationDispense.dosageInstruction.patientInstruction
                                                                                    Definition

                                                                                    Instructions in terms that are understood by the patient or consumer.

                                                                                    ShortPatient or consumer oriented instructions
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    280. MedicationDispense.dosageInstruction.timing
                                                                                    Definition

                                                                                    When medication should be administered.

                                                                                    ShortWhen medication should be administered
                                                                                    Comments

                                                                                    This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

                                                                                    Control0..1
                                                                                    TypeTiming
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    282. MedicationDispense.dosageInstruction.asNeeded[x]
                                                                                    Definition

                                                                                    Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                                                                    ShortTake "as needed" (for x)
                                                                                    Comments

                                                                                    Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                                                                                    Control0..1
                                                                                    BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                                                                    (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.3.0)
                                                                                    TypeChoice of: boolean, CodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    284. MedicationDispense.dosageInstruction.site
                                                                                    Definition

                                                                                    Body site to administer to.

                                                                                    ShortBody site to administer to
                                                                                    Comments

                                                                                    If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                                                                                    Control0..1
                                                                                    BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                                                                    (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.3.0)
                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    A coded specification of the anatomic site where the medication first enters the body.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    286. MedicationDispense.dosageInstruction.route
                                                                                    Definition

                                                                                    How drug should enter body.

                                                                                    ShortHow drug should enter body
                                                                                    Control0..1
                                                                                    BindingFor example codes, see SNOMEDCTRouteCodes
                                                                                    (example to http://hl7.org/fhir/ValueSet/route-codes|4.3.0)
                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    288. MedicationDispense.dosageInstruction.method
                                                                                    Definition

                                                                                    Technique for administering medication.

                                                                                    ShortTechnique for administering medication
                                                                                    Comments

                                                                                    Terminologies used often pre-coordinate this term with the route and or form of administration.

                                                                                    Control0..1
                                                                                    BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                                                                    (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.3.0)
                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    290. MedicationDispense.dosageInstruction.doseAndRate
                                                                                    Definition

                                                                                    The amount of medication administered.

                                                                                    ShortAmount of medication administered
                                                                                    Control0..*
                                                                                    TypeElement
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                                    292. MedicationDispense.dosageInstruction.doseAndRate.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    294. MedicationDispense.dosageInstruction.doseAndRate.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    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.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 296. MedicationDispense.dosageInstruction.doseAndRate.type
                                                                                      Definition

                                                                                      The kind of dose or rate specified, for example, ordered or calculated.

                                                                                      ShortThe kind of dose or rate specified
                                                                                      Control0..1
                                                                                      BindingFor example codes, see DoseAndRateType
                                                                                      (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.3.0)
                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      If the type is not populated, assume to be "ordered".

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      298. MedicationDispense.dosageInstruction.doseAndRate.dose[x]
                                                                                      Definition

                                                                                      Amount of medication per dose.

                                                                                      ShortAmount of medication per dose
                                                                                      Comments

                                                                                      Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                                                                      Control0..1
                                                                                      TypeChoice of: Range, Quantity(SimpleQuantity)
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      The amount of therapeutic or other substance given at one administration event.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      300. MedicationDispense.dosageInstruction.doseAndRate.rate[x]
                                                                                      Definition

                                                                                      Amount of medication per unit of time.

                                                                                      ShortAmount of medication per unit of time
                                                                                      Comments

                                                                                      It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                                                                      It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                                                                      Control0..1
                                                                                      TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      302. MedicationDispense.dosageInstruction.maxDosePerPeriod
                                                                                      Definition

                                                                                      Upper limit on medication per unit of time.

                                                                                      ShortUpper limit on medication per unit of time
                                                                                      Comments

                                                                                      This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                                                                      Control0..1
                                                                                      TypeRatio
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      304. MedicationDispense.dosageInstruction.maxDosePerAdministration
                                                                                      Definition

                                                                                      Upper limit on medication per administration.

                                                                                      ShortUpper limit on medication per administration
                                                                                      Comments

                                                                                      This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                                                                                      Control0..1
                                                                                      TypeQuantity(SimpleQuantity)
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      306. MedicationDispense.dosageInstruction.maxDosePerLifetime
                                                                                      Definition

                                                                                      Upper limit on medication per lifetime of the patient.

                                                                                      ShortUpper limit on medication per lifetime of the patient
                                                                                      Control0..1
                                                                                      TypeQuantity(SimpleQuantity)
                                                                                      Is Modifierfalse
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      308. MedicationDispense.substitution
                                                                                      Definition

                                                                                      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.

                                                                                      ShortWhether a substitution was performed on the dispense
                                                                                      Control0..1
                                                                                      TypeBackboneElement
                                                                                      Is Modifierfalse
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                                                      310. MedicationDispense.substitution.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      312. MedicationDispense.substitution.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      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.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      314. MedicationDispense.substitution.modifierExtension
                                                                                      Definition

                                                                                      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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                      Comments

                                                                                      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.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      316. MedicationDispense.substitution.wasSubstituted
                                                                                      Definition

                                                                                      True if the dispenser dispensed a different drug or product from what was prescribed.

                                                                                      ShortWhether a substitution was or was not performed on the dispense
                                                                                      Control1..1
                                                                                      Typeboolean
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      318. MedicationDispense.substitution.type
                                                                                      Definition

                                                                                      A code signifying whether a different drug was dispensed from what was prescribed.

                                                                                      ShortCode signifying whether a different drug was dispensed from what was prescribed
                                                                                      Control0..1
                                                                                      BindingFor example codes, see ActSubstanceAdminSubstitutionCode (3.0.0)
                                                                                      (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode|3.0.0)

                                                                                      ActSubstanceAdminSubstitutionCode

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      320. MedicationDispense.substitution.reason
                                                                                      Definition

                                                                                      Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

                                                                                      ShortWhy was substitution made
                                                                                      Control0..*
                                                                                      BindingFor example codes, see SubstanceAdminSubstitutionReason (3.0.0)
                                                                                      (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason|3.0.0)

                                                                                      SubstanceAdminSubstitutionReason

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      322. MedicationDispense.substitution.responsibleParty
                                                                                      Definition

                                                                                      The person or organization that has primary responsibility for the substitution.

                                                                                      ShortWho is responsible for the substitution
                                                                                      Control0..*
                                                                                      TypeReference(Practitioner, PractitionerRole)
                                                                                      Is Modifierfalse
                                                                                      Must Supportfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      324. MedicationDispense.substitution.responsibleParty.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typeid
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      326. MedicationDispense.substitution.responsibleParty.extension
                                                                                      Definition

                                                                                      An Extension

                                                                                      ShortExtension
                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      SlicingThis element introduces a set of slices on MedicationDispense.substitution.responsibleParty.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 328. MedicationDispense.substitution.responsibleParty.extension:responsibleParty
                                                                                        Slice NameresponsibleParty
                                                                                        Definition

                                                                                        STU3: MedicationDispense.substitution.responsibleParty additional types from child elements (display, identifier, reference)

                                                                                        ShortSTU3: responsibleParty additional types
                                                                                        Comments

                                                                                        Element MedicationDispense.substitution.responsibleParty is mapped to FHIR R4B element MedicationDispense.substitution.responsibleParty as SourceIsBroaderThanTarget. The mappings for MedicationDispense.substitution.responsibleParty do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.substitution.responsibleParty with unmapped reference targets: Practitioner.

                                                                                        Control0..1
                                                                                        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        330. MedicationDispense.substitution.responsibleParty.reference
                                                                                        Definition

                                                                                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                        ShortLiteral reference, Relative, internal or absolute URL
                                                                                        Comments

                                                                                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ref-1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        332. MedicationDispense.substitution.responsibleParty.type
                                                                                        Definition

                                                                                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                        ShortType the reference refers to (e.g. "Patient")
                                                                                        Comments

                                                                                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                        Control0..1
                                                                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                                        Typeuri
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        334. MedicationDispense.substitution.responsibleParty.identifier
                                                                                        Definition

                                                                                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                        ShortLogical reference, when literal reference is not known
                                                                                        Comments

                                                                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                        Control0..1
                                                                                        TypeIdentifier
                                                                                        Is Modifierfalse
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        336. MedicationDispense.substitution.responsibleParty.display
                                                                                        Definition

                                                                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                        ShortText alternative for the resource
                                                                                        Comments

                                                                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        338. MedicationDispense.detectedIssue
                                                                                        Definition

                                                                                        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.

                                                                                        ShortClinical issue with action
                                                                                        Comments

                                                                                        This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                                                                                        Control0..*
                                                                                        TypeReference(DetectedIssue)
                                                                                        Is Modifierfalse
                                                                                        Must Supportfalse
                                                                                        Summaryfalse
                                                                                        Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        340. MedicationDispense.detectedIssue.id
                                                                                        Definition

                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typeid
                                                                                        Is Modifierfalse
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Summaryfalse
                                                                                        342. MedicationDispense.detectedIssue.extension
                                                                                        Definition

                                                                                        An Extension

                                                                                        ShortExtension
                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        SlicingThis element introduces a set of slices on MedicationDispense.detectedIssue.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 344. MedicationDispense.detectedIssue.extension:detectedIssue
                                                                                          Slice NamedetectedIssue
                                                                                          Definition

                                                                                          STU3: MedicationDispense.detectedIssue additional types from child elements (display, identifier, reference)

                                                                                          ShortSTU3: detectedIssue additional types
                                                                                          Comments

                                                                                          Element MedicationDispense.detectedIssue is mapped to FHIR R4B element MedicationDispense.detectedIssue as SourceIsBroaderThanTarget. The mappings for MedicationDispense.detectedIssue do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.detectedIssue with unmapped reference targets: DetectedIssue.

                                                                                          Control0..1
                                                                                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          346. MedicationDispense.detectedIssue.reference
                                                                                          Definition

                                                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                                          Comments

                                                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ref-1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          348. MedicationDispense.detectedIssue.type
                                                                                          Definition

                                                                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                          ShortType the reference refers to (e.g. "Patient")
                                                                                          Comments

                                                                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                          Control0..1
                                                                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                                          Typeuri
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          350. MedicationDispense.detectedIssue.identifier
                                                                                          Definition

                                                                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                          ShortLogical reference, when literal reference is not known
                                                                                          Comments

                                                                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                          Control0..1
                                                                                          TypeIdentifier
                                                                                          Is Modifierfalse
                                                                                          Summarytrue
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          352. MedicationDispense.detectedIssue.display
                                                                                          Definition

                                                                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                          ShortText alternative for the resource
                                                                                          Comments

                                                                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          354. MedicationDispense.eventHistory
                                                                                          Definition

                                                                                          A summary of the events of interest that have occurred, such as when the dispense was verified.

                                                                                          ShortA list of relevant lifecycle events
                                                                                          Comments

                                                                                          This might 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.).

                                                                                          Control0..*
                                                                                          TypeReference(Provenance)
                                                                                          Is Modifierfalse
                                                                                          Must Supportfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          356. MedicationDispense.eventHistory.id
                                                                                          Definition

                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typeid
                                                                                          Is Modifierfalse
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          Summaryfalse
                                                                                          358. MedicationDispense.eventHistory.extension
                                                                                          Definition

                                                                                          An Extension

                                                                                          ShortExtension
                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          SlicingThis element introduces a set of slices on MedicationDispense.eventHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 360. MedicationDispense.eventHistory.extension:eventHistory
                                                                                            Slice NameeventHistory
                                                                                            Definition

                                                                                            STU3: MedicationDispense.eventHistory additional types from child elements (display, identifier, reference)

                                                                                            ShortSTU3: A list of releveant lifecycle events additional types
                                                                                            Comments

                                                                                            Element MedicationDispense.eventHistory is mapped to FHIR R4B element MedicationDispense.eventHistory as SourceIsBroaderThanTarget. The mappings for MedicationDispense.eventHistory do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element MedicationDispense.eventHistory with unmapped reference targets: Provenance. 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.).

                                                                                            Control0..1
                                                                                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            362. MedicationDispense.eventHistory.reference
                                                                                            Definition

                                                                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                            ShortLiteral reference, Relative, internal or absolute URL
                                                                                            Comments

                                                                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ref-1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            364. MedicationDispense.eventHistory.type
                                                                                            Definition

                                                                                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                                            ShortType the reference refers to (e.g. "Patient")
                                                                                            Comments

                                                                                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                                            Control0..1
                                                                                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                                            (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                                                            Typeuri
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            366. MedicationDispense.eventHistory.identifier
                                                                                            Definition

                                                                                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                            ShortLogical reference, when literal reference is not known
                                                                                            Comments

                                                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                            Control0..1
                                                                                            TypeIdentifier
                                                                                            Is Modifierfalse
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            368. MedicationDispense.eventHistory.display
                                                                                            Definition

                                                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                            ShortText alternative for the resource
                                                                                            Comments

                                                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))