Release 4B Ballot #1

This page is part of the FHIR Specification (v4.1.0: Release 4B Ballot #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Medicationdispense0318.xml

Pharmacy Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner

Raw XML (canonical form + also see XML Format Specification)

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Dispense for Levothyroxine (NDC code) in-progress with authorizing prescription (id = "meddisp0318")

<?xml version="1.0" encoding="UTF-8"?>

<MedicationDispense xmlns="http://hl7.org/fhir">
    <id value="meddisp0318"/> 
    <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative</b> </p> <p> <b> identifier</b> : id: 12345689 (OFFICIAL)</p> <p> <b> status</b> : in-progress</p> <p> <b> medication</b> : <span> Levothyroxine Sodium Tablets, USP (75mcg)</span> </p> <p> <b> subject</b> : <a> Donald Duck. Generated Summary: Medical record number: 654321 (USUAL); active; Duck Donald
           (OFFICIAL); gender: male</a> </p> <h3> Performers</h3> <table> <tr> <td> -</td> <td> <b> Actor</b> </td> </tr> <tr> <td> *</td> <td> <a> Generated Summary: id: 937223645 (OFFICIAL), id: 134IDY41W988 (USUAL); Rob van den Berk
               (OFFICIAL); Phone: 0205569288, R.A.vandenberk@bmc.nl, Fax: 0205664987; gender: male; birthDate:
               1975-12-07</a> </td> </tr> </table> <p> <b> authorizingPrescription</b> : <a> Generated Summary: id: 12345689 (OFFICIAL); status: completed; intent: order; priority:
           routine; <span> Levothyroxine Sodium 75micrograms tablet (product)</span> ; authoredOn: 2015-01-15; <span> Hypothyroidism (disorder)</span> </a> </p> <p> <b> type</b> : <span> Refill - Part Fill</span> </p> <p> <b> quantity</b> : 100 TAB</p> <p> <b> daysSupply</b> : 30 Day</p> <p> <b> whenPrepared</b> : 16 Mar. 2015, 11:13:00 pm</p> <h3> DosageInstructions</h3> <table> <tr> <td> -</td> </tr> <tr> <td> *</td> </tr> </table> <h3> Substitutions</h3> <table> <tr> <td> -</td> <td> <b> WasSubstituted</b> </td> <td> <b> Type</b> </td> <td> <b> Reason</b> </td> <td> <b> ResponsibleParty</b> </td> </tr> <tr> <td> *</td> <td> true</td> <td> <span> formulary</span> </td> <td> <span> Formulary Policy</span> </td> <td> <a> Generated Summary: id: 937223645 (OFFICIAL), id: 134IDY41W988 (USUAL); Rob van den Berk
               (OFFICIAL); Phone: 0205569288, R.A.vandenberk@bmc.nl, Fax: 0205664987; gender: male; birthDate:
               1975-12-07</a> </td> </tr> </table> </div> </text> <identifier> 
        <use value="official"/> 
        <system value="http://www.bmc.nl/portal/dispenses"/> 
        <value value="12345689"/> 
    </identifier> 
    <status value="in-progress"/> 
    <medicationCodeableConcept> 
        <coding> 
            <system value="http://hl7.org/fhir/sid/ndc"/> 
            <code value="0378-1800-10"/> 
            <display value="Levothyroxine Sodium Tablets, USP (75mcg)"/> 
        </coding> 
    </medicationCodeableConcept> 
    <subject> 
        <reference value="Patient/pat1"/> 
        <display value="Donald Duck"/> 
    </subject> 
    <performer> 
        <actor> 
            <reference value="Practitioner/f006"/> 
        </actor> 
    </performer> 
    <authorizingPrescription> 
        <reference value="MedicationRequest/medrx0314"/> 
    </authorizingPrescription> 
    <type> 
        <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
            <code value="RFP"/> 
            <display value="Refill - Part Fill"/> 
        </coding> 
    </type> 
    <quantity> 
        <value value="100"/> 
        <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
        <code value="TAB"/> 
    </quantity> 
    <daysSupply> 
        <value value="30"/> 
        <unit value="Day"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="d"/> 
    </daysSupply> 
    <whenPrepared value="2015-03-16T17:13:00+05:00"/> 
    <dosageInstruction> 
        <sequence value="1"/> 
        <text value="75mcg daily daily"/> 
        <timing> 
            <repeat> 
                <frequency value="1"/> 
                <period value="1"/> 
                <periodUnit value="d"/> 
            </repeat> 
        </timing> 
        <route> 
            <coding> 
                <system value="http://snomed.info/sct"/> 
                <code value="26643006"/> 
                <display value="Oral Route (qualifier value)"/> 
            </coding> 
        </route> 
        <doseAndRate> 
            <type> 
                <coding> 
                    <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/> 
                    <code value="ordered"/> 
                    <display value="Ordered"/> 
                </coding> 
            </type> 
            <doseQuantity> 
                <value value="75"/> 
                <unit value="mcg"/> 
                <system value="http://unitsofmeasure.org"/> 
                <code value="ug"/> 
            </doseQuantity> 
        </doseAndRate> 

    </dosageInstruction>  
<substitution> 
    <wasSubstituted value="true"/> 
    <type> 
        <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution"/> 
            <code value="F"/> 
            <display value="formulary"/> 
        </coding> 
    </type> 
    <reason> 
        <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/> 
            <code value="FP"/> 
            <display value="Formulary Policy"/> 
        </coding> 
    </reason> 
    <responsibleParty> 
        <reference value="Practitioner/f006"/> 
    </responsibleParty> 
</substitution> 
</MedicationDispense> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.