Release 4B

This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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 R2

Medicationdispense.profile.xml

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

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

Jump past Narrative

StructureDefinition for medicationdispense

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

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="MedicationDispense"/> 
  <meta> 
    <lastUpdated value="2022-05-28T12:47:40.239+10:00"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
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          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="The logical name of the element">Name</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Information about the use of the element">Flags</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> 
          </th> 
          <th class="hierarchy" style="width: 100px">
            <a href="formats.html#table" title="Reference to the type of the element">Type</a> 
          </th> 
          <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="formats.html#table" title="Additional information about the element">Description &amp; Constraints</a> 
            <span style="float: right">
              <a href="formats.html#table" title="Legend for this format">
                <img alt="doco" src="help16.png" style="background-color: inherit"/> 
              </a> 
            </span> 
          </th> 
        </tr> 
        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            ABJRU5ErkJggg==" style="background-color: white; background-color: inherit" title="Resource"/>  
            <span title="MedicationDispense : 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.">MedicationDispense</span> 
            <a name="MedicationDispense"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="versions.html#std-process" style="padding-left: 3px; padding-right: 3px; border: 1px grey solid; font-weight: bold; color:
             black; background-color: #fff5e6" title="Standards Status = Trial Use">TU</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="domainresource.html">DomainResource</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Dispensing a medication to a named patient
            <br/>  
            <span style="font-style: italic" title="mdd-1">+ Rule: whenHandedOver cannot be before whenPrepared</span> 
            <br/>  Elements defined in Ancestors: 
            <a href="resource.html#Resource" title="The logical id of the resource, as used in the URL for the resource. Once assigned, this
             value never changes.">id</a> , 
            <a href="resource.html#Resource" title="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.">meta</a> , 
            <a href="resource.html#Resource" title="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.">implicitRules</a> , 
            <a href="resource.html#Resource" title="The base language in which the resource is written.">language</a> , 
            <a href="domainresource.html#DomainResource" title="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 &quot;clinically
             safe&quot; for a human to just read the narrative. Resource definitions may define what
             content should be represented in the narrative to ensure clinical safety.">text</a> , 
            <a href="domainresource.html#DomainResource" title="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.">contained</a> , 
            <a href="domainresource.html#DomainResource" title="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.">extension</a> , 
            <a href="domainresource.html#DomainResource" title="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).">modifierExtension</a> 
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <span title="MedicationDispense.identifier : 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.">identifier</span> 
            <a name="MedicationDispense.identifier"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#Identifier">Identifier</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">External identifier
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.partOf : The procedure that trigger the dispense.">partOf</span> 
            <a name="MedicationDispense.partOf"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="procedure.html">Procedure</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Event that dispense is part of
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAARk
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            RgwAAAABJRU5ErkJggg==" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="MedicationDispense.status : A code specifying the state of the set of dispense events.">status</span> 
            <a name="MedicationDispense.status"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="conformance-rules.html#isModifier" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is a modifier element">?!</a> 
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#code">code</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped
             | declined | unknown
            <br/>  
            <a href="valueset-medicationdispense-status.html">MedicationDispense Status Codes</a>  (
            <a href="terminologies.html#required" title="To be conformant, the concept in this element SHALL be from the specified value set.">Required</a> )
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.statusReason[x] : Indicates the reason why a dispense was not performed.">statusReason[x]</span> 
            <a name="MedicationDispense.statusReason_x_"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Why a dispense was not performed
            <br/>  
            <a href="valueset-medicationdispense-status-reason.html">MedicationDispense Status Reason Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
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            <span title="A concept that may be defined by a formal reference to a terminology or ontology or may
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
        </tr> 

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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="references.html#Reference">Reference</a> (
            <a href="detectedissue.html">DetectedIssue</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.category : Indicates the type of medication dispense (for example,
             where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).">category</span> 
            <a name="MedicationDispense.category"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Type of medication dispense
            <br/>  
            <a href="valueset-medicationdispense-category.html">MedicationDispense Category Codes</a>  (
            <a href="terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes
             but are not required to do so to be considered conformant.">Preferred</a> )
          </td> 
        </tr> 

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            <span title="MedicationDispense.medication[x] : 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.">medication[x]</span> 
            <a name="MedicationDispense.medication_x_"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">What medication was supplied
            <br/>  
            <a href="valueset-medication-codes.html">SNOMED CT Medication Codes</a>  (
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             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
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            zv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866OU
            Pvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6if
            3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///wD/ACH5BAEKAH8ALAAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hYw
            bdkoBPnaQkosbG3d3VEpSUlonUoY1Gzo6QkI8SrGxWBOFG4uySgY5ZWR3PFy2hnaWZXC/PHcPwkpJk1ShoHcxhQEXSUmtFy6+0iSF
            VResrjoTPDzdcoU+F65CduVU6KAhhQa3F8Tx8nchBoYuqoTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="A concept that may be defined by a formal reference to a terminology or ontology or may
             be provided by text.">medicationCodeableConcept</span> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
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          PVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  medicationReference
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <a href="references.html#Reference">Reference</a> (
            <a href="medication.html">Medication</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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        </tr> 

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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
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            <span title="MedicationDispense.subject : A link to a resource representing the person or the group
             to whom the medication will be given.">subject</span> 
            <a name="MedicationDispense.subject"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="group.html">Group</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Who the dispense is for</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
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            <span title="MedicationDispense.context : The encounter or episode of care that establishes the context
             for this event.">context</span> 
            <a name="MedicationDispense.context"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="encounter.html">Encounter</a>  | 
            <a href="episodeofcare.html">EpisodeOfCare</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Encounter / Episode associated with event</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
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            <span title="MedicationDispense.supportingInformation : Additional information that supports the medication
             being dispensed.">supportingInformation</span> 
            <a name="MedicationDispense.supportingInformation"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="resourcelist.html">Any</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Information that supports the dispensing of the medication
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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            <span title="MedicationDispense.performer : Indicates who or what performed the event.">performer</span> 
            <a name="MedicationDispense.performer"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
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          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who performed event
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <span title="MedicationDispense.performer.function : Distinguishes the type of performer in the dispense.
              For example, date enterer, packager, final checker.">function</span> 
            <a name="MedicationDispense.performer.function"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Who performed the dispense and what they did
            <br/>  
            <a href="valueset-medicationdispense-performer-function.html">MedicationDispense Performer Function Codes</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
          oAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCs
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.performer.actor : The device, practitioner, etc. who performed the
             action.  It should be assumed that the actor is the dispenser of the medication.">actor</span> 
            <a name="MedicationDispense.performer.actor"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a>  | 
            <a href="organization.html">Organization</a>  | 
            <a href="patient.html">Patient</a>  | 
            <a href="device.html">Device</a>  | 
            <a href="relatedperson.html">RelatedPerson</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Individual who was performing</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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          EQAAgCsPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.location : The principal physical location where the dispense was performed.">location</span> 
            <a name="MedicationDispense.location"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="location.html">Location</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Where the dispense occurred</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
          oAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCs
          PVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.authorizingPrescription : Indicates the medication order that is being
             dispensed against.">authorizingPrescription</span> 
            <a name="MedicationDispense.authorizingPrescription"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="medicationrequest.html">MedicationRequest</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Medication order that authorizes the dispense
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
          ORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6E
          EQAAgCsPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQka
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            <span title="MedicationDispense.type : Indicates the type of dispensing event that is performed. For
             example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.">type</span> 
            <a name="MedicationDispense.type"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Trial fill, partial fill, emergency fill, etc.
            <br/>  
            <a href="http://terminology.hl7.org/3.1.0/ValueSet-v3-ActPharmacySupplyType.html">ActPharmacySupplyType</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
          oAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCs
          PVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            bdkoBPnaQkosbG3d3VEpSUlonUoY1Gzo6QkI8SrGxWBOFG4uySgY5ZWR3PFy2hnaWZXC/PHcPwkpJk1ShoHcxhQEXSUmtFy6+0iSF
            VResrjoTPDzdcoU+F65CduVU6KAhhQa3F8Tx8nchBoYuqoTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7" style="background-color: white; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.quantity : The amount of medication that has been dispensed. Includes
             unit of measure.">quantity</span> 
            <a name="MedicationDispense.quantity"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Amount dispensed</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
          ORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6E
          EQAAgCsPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav7
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQka
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            zv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866OU
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            3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///wD/ACH5BAEKAH8ALAAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hYw
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            <span title="MedicationDispense.daysSupply : The amount of medication expressed as a timing amount.">daysSupply</span> 
            <a name="MedicationDispense.daysSupply"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Amount of medication expressed as a timing amount</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
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          PVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            dCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav7
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAARk
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            <span title="MedicationDispense.whenPrepared : The time when the dispensed product was packaged and
             reviewed.">whenPrepared</span> 
            <a name="MedicationDispense.whenPrepared"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="elementdefinition-definitions.html#ElementDefinition.isSummary" style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element is included in summaries">Σ</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">When product was packaged and reviewed</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
          ORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6E
          EQAAgCsPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAwN
            dCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav7
            /2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAARk
            lEQVQ4y2P8//8/AyWAhYFCMAgMuHjx4n+KXaCv+I0szW8WpCG8kFO1lGFKW/SIjAUYgxz/MzAwMDC+nqhDUTQyjuYFBgCNmhP4OvT
            RgwAAAABJRU5ErkJggg==" style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type"/>  
            <span title="MedicationDispense.whenHandedOver : The time the dispensed product was provided to the
             patient or their representative.">whenHandedOver</span> 
            <a name="MedicationDispense.whenHandedOver"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#dateTime">dateTime</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">When product was given out</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
          oAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCs
          PVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav7
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
            v8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjEE
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.destination : Identification of the facility/location where the medication
             was shipped to, as part of the dispense event.">destination</span> 
            <a name="MedicationDispense.destination"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="location.html">Location</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Where the medication was sent</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
          ORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6E
          EQAAgCsPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAwN
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav7
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.receiver : 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.">receiver</span> 
            <a name="MedicationDispense.receiver"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="patient.html">Patient</a>  | 
            <a href="practitioner.html">Practitioner</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Who collected the medication
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
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          PVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAwN
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav7
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQka
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            zv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866OU
            Pvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6if
            3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///wD/ACH5BAEKAH8ALAAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hYw
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            <span title="MedicationDispense.note : Extra information about the dispense that could not be conveyed
             in the other attributes.">note</span> 
            <a name="MedicationDispense.note"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#Annotation">Annotation</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Information about the dispense
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQka
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            <span title="MedicationDispense.dosageInstruction : Indicates how the medication is to be used by the
             patient.">dosageInstruction</span> 
            <a name="MedicationDispense.dosageInstruction"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="dosage.html#Dosage">Dosage</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">How the medication is to be used by the patient or administered by the caregiver
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw/
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            <span title="MedicationDispense.substitution : 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.">substitution</span> 
            <a name="MedicationDispense.substitution"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="backboneelement.html">BackboneElement</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Whether a substitution was performed on the dispense</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
          ORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+
          5QQAAOCZBkurQFbnaRSlAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAACXBIWXMAAAsTAAALEwEAmpwYAAAARk
            lEQVQ4y2P8//8/AyWAhYFCMAgMuHjx4n+KXaCv+I0szW8WpCG8kFO1lGFKW/SIjAUYgxz/MzAwMDC+nqhDUTQyjuYFBgCNmhP4OvT
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            <span title="MedicationDispense.substitution.wasSubstituted : True if the dispenser dispensed a different
             drug or product from what was prescribed.">wasSubstituted</span> 
            <a name="MedicationDispense.substitution.wasSubstituted"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">1..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#boolean">boolean</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Whether a substitution was or was not performed on the dispense</td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
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          ZBkurQFbnaRSlAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQka
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            <span title="MedicationDispense.substitution.type : A code signifying whether a different drug was
             dispensed from what was prescribed.">type</span> 
            <a name="MedicationDispense.substitution.type"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..1</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Code signifying whether a different drug was dispensed from what was prescribed
            <br/>  
            <a href="http://terminology.hl7.org/3.1.0/ValueSet-v3-ActSubstanceAdminSubstitutionCode.html">ActSubstanceAdminSubstitutionCode</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
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          5QQAAOCZBkurQFbnaRSlAAAAAElFTkSuQmCC)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            <img alt="." class="hierarchy" src="data:image/png;base64,R0lGODlhEAAQAPZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQka
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            Pvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6if
            3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///wD/ACH5BAEKAH8ALAAAAAAQABAAAAemgH+CgxeFF4OIhBdKGwFChYl/hYw
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            VResrjoTPDzdcoU+F65CduVU6KAhhQa3F8Tx8nchBoYuqoTLZoAKFRIhqGwqJAULFx0GYpBQeChRIR4TJm6KJMhQRUSBAAA7" style="background-color: #F7F7F7; background-color: inherit" title="Data Type"/>  
            <span title="MedicationDispense.substitution.reason : Indicates the reason for the substitution (or
             lack of substitution) from what was prescribed.">reason</span> 
            <a name="MedicationDispense.substitution.reason"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="datatypes.html#CodeableConcept">CodeableConcept</a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Why was substitution made
            <br/>  
            <a href="http://terminology.hl7.org/3.1.0/ValueSet-v3-SubstanceAdminSubstitutionReason.html">SubstanceAdminSubstitutionReason</a>  (
            <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set.  The
             value set merely provides examples of the types of concepts intended to be included.">Example</a> )
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
          oAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCs
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
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            dCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwAv
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUOL
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
            v8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjEE
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.substitution.responsibleParty : The person or organization that has
             primary responsibility for the substitution.">responsibleParty</span> 
            <a name="MedicationDispense.substitution.responsibleParty"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="practitioner.html">Practitioner</a>  | 
            <a href="practitionerrole.html">PractitionerRole</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">Who is responsible for the substitution
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVB
          ORw0KGgoAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6E
          EQAAgCsPVYVAgIJrA/sAAAAASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAwN
            dCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav7
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
            v8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjEE
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            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.detectedIssue : 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.">detectedIssue</span> 
            <a name="MedicationDispense.detectedIssue"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="detectedissue.html">DetectedIssue</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0
           solid; padding:0px 4px 0px 4px">Clinical issue with action
            <br/>  
          </td> 
        </tr> 

        <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data:image/png;base64,iVBORw0KGg
          oAAAANSUhEUgAAAyAAAAACCAYAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkRjgNAAAAA
          ASUVORK5CYII=)">
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAwN
            dCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> 
            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3
            RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUOL
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            <img alt="." class="hierarchy" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxjw
            v8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjEE
            OACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQK
            lQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/>  
            <span title="MedicationDispense.eventHistory : A summary of the events of interest that have occurred,
             such as when the dispense was verified.">eventHistory</span> 
            <a name="MedicationDispense.eventHistory"> </a> 
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px"/> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">0..*</td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">
            <a href="references.html#Reference">Reference</a> (
            <a href="provenance.html">Provenance</a> )
          </td> 
          <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid;
           padding:0px 4px 0px 4px">A list of relevant lifecycle events
            <br/>  
          </td> 
        </tr> 

        <tr> 
          <td class="hierarchy" colspan="5">
            <br/>  
            <a href="formats.html#table" title="Legend for this format">
              <img alt="doco" src="help16.png" style="background-color: inherit"/>  Documentation for this format
            </a> 
          </td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-category">
    <valueString value="Clinical.Medications"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category">
    <valueCode value="patient"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="phx"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> 
  <version value="4.3.0"/> 
  <name value="MedicationDispense"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2022-05-28T12:47:40+10:00"/> 
  <publisher value="Health Level Seven International (Pharmacy)"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://www.hl7.org/Special/committees/medication/index.cfm"/> 
    </telecom> 
  </contact> 
  <description value="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."/> 
  <fhirVersion value="4.3.0"/> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="rx-dispense-rmim"/> 
    <uri value="http://www.hl7.org/v3/PORX_RM020070UV"/> 
    <name value="V3 Pharmacy Dispense RMIM"/> 
  </mapping> 
  <mapping> 
    <identity value="v2"/> 
    <uri value="http://hl7.org/v2"/> 
    <name value="HL7 v2 Mapping"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="MedicationDispense"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
  <derivation value="specialization"/> 
  <snapshot> 
    <element id="MedicationDispense">
      <path value="MedicationDispense"/> 
      <short value="Dispensing a medication to a named patient"/> 
      <definition value="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."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="dom-2"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> 
        <expression value="contained.contained.empty()"/> 
        <xpath value="not(parent::f:contained and f:contained)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-3"/> 
        <severity value="error"/> 
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere
         in the resource or SHALL refer to the containing resource"/> 
        <expression value="contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descenda
        nts().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()"/> 
        <xpath value="not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:refere
        nce/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-4"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or
         a meta.lastUpdated"/> 
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="dom-5"/> 
        <severity value="error"/> 
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> 
        <expression value="contained.meta.security.empty()"/> 
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display
           the resource to a human safely. Including a human readable representation in the resource
           makes for a much more robust eco-system and cheaper handling of resources by intermediary
           systems. Some ecosystems restrict distribution of resources to only those systems that
           do fully understand the resources, and as a consequence implementers may believe that
           the narrative is superfluous. However experience shows that such eco-systems often open
           up to new participants over time."/> 
        </extension> 
        <key value="dom-6"/> 
        <severity value="warning"/> 
        <human value="A resource should have narrative for robust management"/> 
        <expression value="text.`div`.exists()"/> 
        <xpath value="exists(f:text/h:div)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> 
      </constraint> 
      <constraint> 
        <key value="mdd-1"/> 
        <severity value="error"/> 
        <human value="whenHandedOver cannot be before whenPrepared"/> 
        <expression value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver &gt;= whenPrepared"/> 
        <xpath value="not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va
        lue &gt;= f:whenPrepared/@value)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Entity. Role, or Act"/> 
      </mapping> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Supply[moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.id">
      <path value="MedicationDispense.id"/> 
      <short value="Logical id of this artifact"/> 
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this
       value never changes."/> 
      <comment value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationDispense.meta">
      <path value="MedicationDispense.meta"/> 
      <short value="Metadata about the resource"/> 
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content might not always be associated with version changes to the resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationDispense.implicitRules">
      <path value="MedicationDispense.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content. Often, this is a reference to an
       implementation guide that defines the special rules along with other profiles etc."/> 
      <comment value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However, the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element. 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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="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"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="MedicationDispense.language">
      <path value="MedicationDispense.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      <comment value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource. Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="IETF language tag"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
      </binding> 
    </element> 
    <element id="MedicationDispense.text">
      <path value="MedicationDispense.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      <definition value="A human-readable narrative that contains a summary of the resource and 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 &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/> 
      <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative. In some cases, a resource may only have text with little or no additional
       discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary
       for data from legacy systems where information is captured as a &quot;text blob&quot;
       or where text is additionally entered raw or narrated and encoded information is added
       later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.contained">
      <path value="MedicationDispense.contained"/> 
      <short value="Contained, inline Resources"/> 
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/> 
      <comment value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again. Contained
       resources may have profiles and tags In their meta elements, but SHALL NOT have security
       labels."/> 
      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <constraint> 
        <key value="dom-r4b"/> 
        <severity value="warning"/> 
        <human value="Containing new R4B resources within R4 resources may cause interoperability issues if
         instances are shared with R4 systems"/> 
        <expression value="($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 MedicinalProductDefi
        nition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition
         or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorizat
        ion or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource
         is SubscriptionTopic)"/> 
        <xpath value="not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:Package
        dProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedA
        uthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citatio
        n|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDe
        finition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingre
        dient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|
        f:SubscriptionStatus|f:SubscriptionTopic)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.extension">
      <path value="MedicationDispense.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. 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."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.modifierExtension">
      <path value="MedicationDispense.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource and that modifies the understanding of the element that contains it 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)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <requirements value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource
       that contains them"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.identifier">
      <path value="MedicationDispense.identifier"/> 
      <short value="External identifier"/> 
      <definition value="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."/> 
      <comment value="This is a business identifier, not a resource identifier."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.id"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.partOf">
      <path value="MedicationDispense.partOf"/> 
      <short value="Event that dispense is part of"/> 
      <definition value="The procedure that trigger the dispense."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.partOf"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.partOf"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/> 
      <short value="preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped
       | declined | unknown"/> 
      <definition value="A code specifying the state of the set of dispense events."/> 
      <comment value="This element is labeled as a modifier because the status contains codes that mark the
       resource as not currently valid."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="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"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Describes the lifecycle of the dispense."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-status|4.3.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.statusCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.statusReason[x]">
      <path value="MedicationDispense.statusReason[x]"/> 
      <short value="Why a dispense was not performed"/> 
      <definition value="Indicates the reason why a dispense was not performed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.statusReason[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseStatusReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A code describing why a dispense was not performed."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-status-reason"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.statusReason"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;not
         done reason&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.category">
      <path value="MedicationDispense.category"/> 
      <short value="Type of medication dispense"/> 
      <definition value="Indicates the type of medication dispense (for example, where the medication is expected
       to be consumed or administered (i.e. inpatient or outpatient))."/> 
      <comment value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.category"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="A code describing where the dispensed medication is expected to be consumed or administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-category"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type
         of medication dispense&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/> 
      <short value="What medication was supplied"/> 
      <definition value="Identifies the medication being administered. This is either a link to a resource representing
       the details of the medication or a simple attribute carrying a code that identifies the
       medication from a known list of medications."/> 
      <comment value="If only a code is specified, then it needs to be a code for a specific product. If more
       information is required, then the use of the medication resource is recommended.  For
       example, if you require form or lot number, then you must reference the Medication resource."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.medication[x]"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying which substance or product can be dispensed."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-codes"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-2-Dispense/Give Code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRD].role"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationRequest.component1.AdministrationRequest.consumable"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.subject">
      <path value="MedicationDispense.subject"/> 
      <short value="Who the dispense is for"/> 
      <definition value="A link to a resource representing the person or the group to whom the medication will
       be given."/> 
      <comment value="SubstanceAdministration-&gt;subject-&gt;Patient."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.subject"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3-Patient ID List"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.context">
      <path value="MedicationDispense.context"/> 
      <short value="Encounter / Episode associated with event"/> 
      <definition value="The encounter or episode of care that establishes the context for this event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.context"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type
         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.supportingInformation">
      <path value="MedicationDispense.supportingInformation"/> 
      <short value="Information that supports the dispensing of the medication"/> 
      <definition value="Additional information that supports the medication being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.supportingInformation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal
         with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of
         the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS,
         RQO, PRP, APT, ARQ, GOL)]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer">
      <path value="MedicationDispense.performer"/> 
      <short value="Who performed event"/> 
      <definition value="Indicates who or what performed the event."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.performer"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRF]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.id">
      <path value="MedicationDispense.performer.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.extension">
      <path value="MedicationDispense.performer.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. 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."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.modifierExtension">
      <path value="MedicationDispense.performer.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element 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)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <requirements value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.function">
      <path value="MedicationDispense.performer.function"/> 
      <short value="Who performed the dispense and what they did"/> 
      <definition value="Distinguishes the type of performer in the dispense.  For example, date enterer, packager,
       final checker."/> 
      <requirements value="Allows disambiguation of the types of involvement of different performers."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.performer.function"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispensePerformerFunction"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A code describing the role an individual played in dispensing a medication."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-performer-function"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="participation[typeCode=PRF].functionCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.actor">
      <path value="MedicationDispense.performer.actor"/> 
      <short value="Individual who was performing"/> 
      <definition value="The device, practitioner, etc. who performed the action.  It should be assumed that the
       actor is the dispenser of the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.performer.actor"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.location">
      <path value="MedicationDispense.location"/> 
      <short value="Where the dispense occurred"/> 
      <definition value="The principal physical location where the dispense was performed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.location"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=LOC].role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.authorizingPrescription">
      <path value="MedicationDispense.authorizingPrescription"/> 
      <short value="Medication order that authorizes the dispense"/> 
      <definition value="Indicates the medication order that is being dispensed against."/> 
      <comment value="Maps to basedOn in Event logical model."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.authorizingPrescription"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.basedOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ORC-2 Placer Order Number"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.inFulfillmentOf"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.type">
      <path value="MedicationDispense.type"/> 
      <short value="Trial fill, partial fill, emergency fill, etc."/> 
      <definition value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
       of Trial, Partial Fill, Emergency Fill, Samples, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.type"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="ActPharmacySupplyType"/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-33-Dispense Type"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.quantity">
      <path value="MedicationDispense.quantity"/> 
      <short value="Amount dispensed"/> 
      <definition value="The amount of medication that has been dispensed. Includes unit of measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.quantity"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense
         Units.name of coding system"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".quantity"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.quantity"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.daysSupply">
      <path value="MedicationDispense.daysSupply"/> 
      <short value="Amount of medication expressed as a timing amount"/> 
      <definition value="The amount of medication expressed as a timing amount."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.daysSupply"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TQ1.6 Timing/Quantity Segment Service Duration.
Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component.  This
         is a formatted string, first character for the time unit (e.g., D=days), followed by the
         value.  For example, “D14” represents “14 days supply”
From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration.  This is a CQ data type
         (&lt;Quantity (NM)&gt; ^ &lt;Units (CWE)&gt;), thus for days supply, assuming the unit
         of measure is “days”, the numeric value is TQ1.6.1 (…|14^
For backwards compatibility, ORC.7 was permitted through v2.6.  Both forms (field and
         segment) may be present in v2.5, v2.5.1, and v2.6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="effectiveUseTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenPrepared">
      <path value="MedicationDispense.whenPrepared"/> 
      <short value="When product was packaged and reviewed"/> 
      <definition value="The time when the dispensed product was packaged and reviewed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.whenPrepared"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].low"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/> 
      <short value="When product was given out"/> 
      <definition value="The time the dispensed product was provided to the patient or their representative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.whenHandedOver"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].high"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.destination">
      <path value="MedicationDispense.destination"/> 
      <short value="Where the medication was sent"/> 
      <definition value="Identification of the facility/location where the medication was shipped to, as part of
       the dispense event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.destination"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy
         Address"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=DST].role"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.destination"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.receiver">
      <path value="MedicationDispense.receiver"/> 
      <short value="Who collected the medication"/> 
      <definition value="Identifies the person who picked up the medication.  This will usually be a patient or
       their caregiver, but some cases exist where it can be a healthcare professional."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.receiver"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=RCV].role"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.receiver"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.note">
      <path value="MedicationDispense.note"/> 
      <short value="Information about the dispense"/> 
      <definition value="Extra information about the dispense that could not be conveyed in the other attributes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.note"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-9 Dispense Notes"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/> 
      <short value="How the medication is to be used by the patient or administered by the caregiver"/> 
      <definition value="Indicates how the medication is to be used by the patient."/> 
      <comment value="When the dose or rate is intended to change over the entire administration period (e.g.
       Tapering dose prescriptions), multiple instances of dosage instructions will need to be
       supplied to convey the different doses/rates.
The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction
       based on the actual product being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.dosageInstruction"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Dosage"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution">
      <path value="MedicationDispense.substitution"/> 
      <short value="Whether a substitution was performed on the dispense"/> 
      <definition value="Indicates whether or not substitution was made as part of the dispense.  In some cases,
       substitution will be expected but does not happen, in other cases substitution is not
       expected but does happen.  This block explains what substitution did or did not happen
       and why.  If nothing is specified, substitution was not done."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.substitution"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children unless an empty Parameters resource"/> 
        <expression value="hasValue() or (children().count() &gt; id.count()) or $this is Parameters"/> 
        <xpath value="@value|f:*|h:div|self::f:Parameters"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.id">
      <path value="MedicationDispense.substitution.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      <definition value="Unique id for the element within a resource (for internal references). This may be any
       string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.extension">
      <path value="MedicationDispense.substitution.extension"/> 
      <short value="Additional content defined by implementations"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. 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."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.modifierExtension">
      <path value="MedicationDispense.substitution.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element 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)."/> 
      <comment value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/> 
      <requirements value="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](extensibility.ht
      ml#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <isModifier value="true"/> 
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element
       that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.wasSubstituted">
      <path value="MedicationDispense.substitution.wasSubstituted"/> 
      <short value="Whether a substitution was or was not performed on the dispense"/> 
      <definition value="True if the dispenser dispensed a different drug or product from what was prescribed."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.substitution.wasSubstituted"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".actionNegationInd"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.type">
      <path value="MedicationDispense.substitution.type"/> 
      <short value="Code signifying whether a different drug was dispensed from what was prescribed"/> 
      <definition value="A code signifying whether a different drug was dispensed from what was prescribed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="MedicationDispense.substitution.type"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="ActSubstanceAdminSubstitutionCode"/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade.code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.reason">
      <path value="MedicationDispense.substitution.reason"/> 
      <short value="Why was substitution made"/> 
      <definition value="Indicates the reason for the substitution (or lack of substitution) from what was prescribed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.substitution.reason"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="SubstanceAdminSubstitutionReason"/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade.reasonCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.responsibleParty">
      <path value="MedicationDispense.substitution.responsibleParty"/> 
      <short value="Who is responsible for the substitution"/> 
      <definition value="The person or organization that has primary responsibility for the substitution."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.substitution.responsibleParty"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade.ResponsibleParty"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.detectedIssue">
      <path value="MedicationDispense.detectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or
       proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy,
       dosage alert etc."/> 
      <comment value="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."/> 
      <alias value="Contraindication"/> 
      <alias value="Drug Utilization Review (DUR)"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.detectedIssue"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.eventHistory">
      <path value="MedicationDispense.eventHistory"/> 
      <short value="A list of relevant lifecycle events"/> 
      <definition value="A summary of the events of interest that have occurred, such as when the dispense was
       verified."/> 
      <comment value="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.)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="MedicationDispense.eventHistory"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <xpath value="@value|f:*|h:div"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="MedicationDispense">
      <path value="MedicationDispense"/> 
      <short value="Dispensing a medication to a named patient"/> 
      <definition value="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."/> 
      <min value="0"/> 
      <max value="*"/> 
      <constraint> 
        <key value="mdd-1"/> 
        <severity value="error"/> 
        <human value="whenHandedOver cannot be before whenPrepared"/> 
        <expression value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver &gt;= whenPrepared"/> 
        <xpath value="not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@va
        lue &gt;= f:whenPrepared/@value)"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Supply[moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="clinical.medication"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.identifier">
      <path value="MedicationDispense.identifier"/> 
      <short value="External identifier"/> 
      <definition value="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."/> 
      <comment value="This is a business identifier, not a resource identifier."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".id"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.id"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.partOf">
      <path value="MedicationDispense.partOf"/> 
      <short value="Event that dispense is part of"/> 
      <definition value="The procedure that trigger the dispense."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.partOf"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.status">
      <path value="MedicationDispense.status"/> 
      <short value="preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped
       | declined | unknown"/> 
      <definition value="A code specifying the state of the set of dispense events."/> 
      <comment value="This element is labeled as a modifier because the status contains codes that mark the
       resource as not currently valid."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="code"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      <isModifierReason value="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"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseStatus"/> 
        </extension> 
        <strength value="required"/> 
        <description value="Describes the lifecycle of the dispense."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-status|4.3.0"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.status"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".statusCode"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.statusCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.statusReason[x]">
      <path value="MedicationDispense.statusReason[x]"/> 
      <short value="Why a dispense was not performed"/> 
      <definition value="Indicates the reason why a dispense was not performed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseStatusReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A code describing why a dispense was not performed."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-status-reason"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.statusReason"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;not
         done reason&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.category">
      <path value="MedicationDispense.category"/> 
      <short value="Type of medication dispense"/> 
      <definition value="Indicates the type of medication dispense (for example, where the medication is expected
       to be consumed or administered (i.e. inpatient or outpatient))."/> 
      <comment value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseCategory"/> 
        </extension> 
        <strength value="preferred"/> 
        <description value="A code describing where the dispensed medication is expected to be consumed or administered."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-category"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type
         of medication dispense&quot;].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.medication[x]">
      <path value="MedicationDispense.medication[x]"/> 
      <short value="What medication was supplied"/> 
      <definition value="Identifies the medication being administered. This is either a link to a resource representing
       the details of the medication or a simple attribute carrying a code that identifies the
       medication from a known list of medications."/> 
      <comment value="If only a code is specified, then it needs to be a code for a specific product. If more
       information is required, then the use of the medication resource is recommended.  For
       example, if you require form or lot number, then you must reference the Medication resource."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationCode"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A coded concept identifying which substance or product can be dispensed."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-codes"/> 
      </binding> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.code"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.what[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-2-Dispense/Give Code"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRD].role"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationRequest.component1.AdministrationRequest.consumable"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.subject">
      <path value="MedicationDispense.subject"/> 
      <short value="Who the dispense is for"/> 
      <definition value="A link to a resource representing the person or the group to whom the medication will
       be given."/> 
      <comment value="SubstanceAdministration-&gt;subject-&gt;Patient."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.subject"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="PID-3-Patient ID List"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> 
      </mapping> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.subject"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.context">
      <path value="MedicationDispense.context"/> 
      <short value="Encounter / Episode associated with event"/> 
      <definition value="The encounter or episode of care that establishes the context for this event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=&quot;type
         of encounter or episode&quot;]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.supportingInformation">
      <path value="MedicationDispense.supportingInformation"/> 
      <short value="Information that supports the dispensing of the medication"/> 
      <definition value="Additional information that supports the medication being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.context"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal
         with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of
         the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS,
         RQO, PRP, APT, ARQ, GOL)]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer">
      <path value="MedicationDispense.performer"/> 
      <short value="Who performed event"/> 
      <definition value="Indicates who or what performed the event."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PRF]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.function">
      <path value="MedicationDispense.performer.function"/> 
      <short value="Who performed the dispense and what they did"/> 
      <definition value="Distinguishes the type of performer in the dispense.  For example, date enterer, packager,
       final checker."/> 
      <requirements value="Allows disambiguation of the types of involvement of different performers."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispensePerformerFunction"/> 
        </extension> 
        <strength value="example"/> 
        <description value="A code describing the role an individual played in dispensing a medication."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-performer-function"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value="participation[typeCode=PRF].functionCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.performer.actor">
      <path value="MedicationDispense.performer.actor"/> 
      <short value="Individual who was performing"/> 
      <definition value="The device, practitioner, etc. who performed the action.  It should be assumed that the
       actor is the dispenser of the medication."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.performer.actor"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.location">
      <path value="MedicationDispense.location"/> 
      <short value="Where the dispense occurred"/> 
      <definition value="The principal physical location where the dispense was performed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=LOC].role"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.authorizingPrescription">
      <path value="MedicationDispense.authorizingPrescription"/> 
      <short value="Medication order that authorizes the dispense"/> 
      <definition value="Indicates the medication order that is being dispensed against."/> 
      <comment value="Maps to basedOn in Event logical model."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.basedOn"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="ORC-2 Placer Order Number"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.inFulfillmentOf"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.type">
      <path value="MedicationDispense.type"/> 
      <short value="Trial fill, partial fill, emergency fill, etc."/> 
      <definition value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion
       of Trial, Partial Fill, Emergency Fill, Samples, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationDispenseType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="ActPharmacySupplyType"/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-33-Dispense Type"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.quantity">
      <path value="MedicationDispense.quantity"/> 
      <short value="Amount dispensed"/> 
      <definition value="The amount of medication that has been dispensed. Includes unit of measure."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense
         Units.name of coding system"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".quantity"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.quantity"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.daysSupply">
      <path value="MedicationDispense.daysSupply"/> 
      <short value="Amount of medication expressed as a timing amount"/> 
      <definition value="The amount of medication expressed as a timing amount."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Quantity"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="TQ1.6 Timing/Quantity Segment Service Duration.
Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component.  This
         is a formatted string, first character for the time unit (e.g., D=days), followed by the
         value.  For example, “D14” represents “14 days supply”
From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration.  This is a CQ data type
         (&lt;Quantity (NM)&gt; ^ &lt;Units (CWE)&gt;), thus for days supply, assuming the unit
         of measure is “days”, the numeric value is TQ1.6.1 (…|14^
For backwards compatibility, ORC.7 was permitted through v2.6.  Both forms (field and
         segment) may be present in v2.5, v2.5.1, and v2.6"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="effectiveUseTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenPrepared">
      <path value="MedicationDispense.whenPrepared"/> 
      <short value="When product was packaged and reviewed"/> 
      <definition value="The time when the dispensed product was packaged and reviewed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].low"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.whenHandedOver">
      <path value="MedicationDispense.whenHandedOver"/> 
      <short value="When product was given out"/> 
      <definition value="The time the dispensed product was provided to the patient or their representative."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.occurrence[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-3-Date/Time Dispensed"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".effectiveTime[xmi:type=IVL_TS].high"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.effectiveTime"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.destination">
      <path value="MedicationDispense.destination"/> 
      <short value="Where the medication was sent"/> 
      <definition value="Identification of the facility/location where the medication was shipped to, as part of
       the dispense event."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy
         Address"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=DST].role"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.destination"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.receiver">
      <path value="MedicationDispense.receiver"/> 
      <short value="Who collected the medication"/> 
      <definition value="Identifies the person who picked up the medication.  This will usually be a patient or
       their caregiver, but some cases exist where it can be a healthcare professional."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=RCV].role"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.SupplyEvent.receiver"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.note">
      <path value="MedicationDispense.note"/> 
      <short value="Information about the dispense"/> 
      <definition value="Extra information about the dispense that could not be conveyed in the other attributes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Annotation"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="workflow"/> 
        <map value="Event.note"/> 
      </mapping> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXD-9 Dispense Notes"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.dosageInstruction">
      <path value="MedicationDispense.dosageInstruction"/> 
      <short value="How the medication is to be used by the patient or administered by the caregiver"/> 
      <definition value="Indicates how the medication is to be used by the patient."/> 
      <comment value="When the dose or rate is intended to change over the entire administration period (e.g.
       Tapering dose prescriptions), multiple instances of dosage instructions will need to be
       supplied to convey the different doses/rates.
The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction
       based on the actual product being dispensed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Dosage"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution">
      <path value="MedicationDispense.substitution"/> 
      <short value="Whether a substitution was performed on the dispense"/> 
      <definition value="Indicates whether or not substitution was made as part of the dispense.  In some cases,
       substitution will be expected but does not happen, in other cases substitution is not
       expected but does happen.  This block explains what substitution did or did not happen
       and why.  If nothing is specified, substitution was not done."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.wasSubstituted">
      <path value="MedicationDispense.substitution.wasSubstituted"/> 
      <short value="Whether a substitution was or was not performed on the dispense"/> 
      <definition value="True if the dispenser dispensed a different drug or product from what was prescribed."/> 
      <min value="1"/> 
      <max value="1"/> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".actionNegationInd"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.type">
      <path value="MedicationDispense.substitution.type"/> 
      <short value="Code signifying whether a different drug was dispensed from what was prescribed"/> 
      <definition value="A code signifying whether a different drug was dispensed from what was prescribed."/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionType"/> 
        </extension> 
        <strength value="example"/> 
        <description value="ActSubstanceAdminSubstitutionCode"/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/> 
      </binding> 
      <mapping> 
        <identity value="v2"/> 
        <map value="RXO-9-Allow Substitutions / RXE-9-Substitution Status"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".code"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade.code"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.reason">
      <path value="MedicationDispense.substitution.reason"/> 
      <short value="Why was substitution made"/> 
      <definition value="Indicates the reason for the substitution (or lack of substitution) from what was prescribed."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationIntendedSubstitutionReason"/> 
        </extension> 
        <strength value="example"/> 
        <description value="SubstanceAdminSubstitutionReason"/> 
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason"/> 
      </binding> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".reasonCode"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade.reasonCode"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.substitution.responsibleParty">
      <path value="MedicationDispense.substitution.responsibleParty"/> 
      <short value="Who is responsible for the substitution"/> 
      <definition value="The person or organization that has primary responsibility for the substitution."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/> 
      </mapping> 
      <mapping> 
        <identity value="rx-dispense-rmim"/> 
        <map value="CombinedMedicationDispense.substitutionMade.ResponsibleParty"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.detectedIssue">
      <path value="MedicationDispense.detectedIssue"/> 
      <short value="Clinical issue with action"/> 
      <definition value="Indicates an actual or potential clinical issue with or between one or more active or
       proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy,
       dosage alert etc."/> 
      <comment value="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."/> 
      <alias value="Contraindication"/> 
      <alias value="Drug Utilization Review (DUR)"/> 
      <alias value="Alert"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value"/> 
      </mapping> 
    </element> 
    <element id="MedicationDispense.eventHistory">
      <path value="MedicationDispense.eventHistory"/> 
      <short value="A list of relevant lifecycle events"/> 
      <definition value="A summary of the events of interest that have occurred, such as when the dispense was
       verified."/> 
      <comment value="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.)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Reference"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/> 
      </mapping> 
    </element> 
  </differential> 
</StructureDefinition> 

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.