2026 US Quality Core Implementation Guide
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2026 US Quality Core Implementation Guide - Downloaded Version 0.5.0 See the Directory of published versions

Resource Profile: US Quality Core MedicationDispense

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationdispense Version: 0.5.0
Active as of 2026-06-05 Computable Name: USQualityCoreMedicationDispense

Profile of MedicationDispense for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

  • status: (USCDI+ Quality) (USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown
  • medication[x]: (USCDI+ Quality) (USCDI) What medication was supplied
  • quantity: (USCDI+ Quality) (USCDI) Amount dispensed
  • daysSupply: (USCDI+ Quality) Amount of medication expressed as a timing amount
  • dosageInstruction: (USCDI+ Quality) (USCDI) How the medication is to be used by the patient or administered by the caregiver
  • dosageInstruction.text: (USCDI+ Quality) (USCDI) Free text dosage instructions e.g. SIG
  • dosageInstruction.timing: (USCDI+ Quality) (USCDI) When medication should be administered
  • dosageInstruction.route: (USCDI+ Quality) How drug should enter body
  • dosageInstruction.doseAndRate: (USCDI+ Quality) (USCDI) Amount of medication administered
  • dosageInstruction.doseAndRate.dose[x]: (USCDI+ Quality) (USCDI) Amount of medication per dose

Because this profile is derived from US Core, systems are also expected to support Must Support requirements and (USCDI) tagged elements inherited from US Core. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Profile Specific Implementation Guidance

To represent that a medication dispense intentionally did not occur for a medical, patient, or system reason, use the US Quality Core MedicationDispense Declined profile.

Additional informational guidance for authoring CQL using this profile is provided in the CQL Authoring Usage (Informational) section of this page.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* USCoreMedicationDispenseProfile(6.1.0) Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣC 1..1 code (USCDI+ Quality) (USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown
Binding: Non-Negative MedicationDispense Status (required)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Quality Core Medication)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the dispense is for
... performer S 0..* BackboneElement (USCDI) Who performed event
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... actor S 1..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) (USCDI) Individual who was performing
... authorizingPrescription S 0..* Reference(US Quality Core MedicationRequest) (USCDI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (USCDI) Trial fill, partial fill, emergency fill, etc.
Binding: V3 Value SetActPharmacySupplyType (extensible)
... quantity S 0..1 Quantity (USCDI+ Quality) (USCDI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... daysSupply 0..1 SimpleQuantity (USCDI+ Quality) Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
... whenHandedOver SC 0..1 dateTime (USCDI) When product was given out or mailed
... dosageInstruction S 0..* Dosage (USCDI+ Quality) (USCDI) How the medication is to be used by the patient or administered by the caregiver
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string (USCDI+ Quality) (USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (USCDI+ Quality) (USCDI) When medication should be administered
.... route Σ 0..1 CodeableConcept (USCDI+ Quality) How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... doseAndRate SΣ 0..* Element (USCDI+ Quality) (USCDI) Amount of medication administered
..... dose[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Non-Negative MedicationDispense Status 📦0.5.0 This IG
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.type Base extensible V3 Value SetActPharmacySupplyType 📦2014-03-26 FHIR Std.
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
us-core-20 error MedicationDispense whenHandedOver SHALL be present if the status is "completed" status='completed' implies whenHandedOver.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense 0..* USCoreMedicationDispenseProfile(6.1.0) Dispensing a medication to a named patient
... status 1..1 code (USCDI+ Quality) (USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown
Binding: Non-Negative MedicationDispense Status (required)
... medication[x] 1..1 (USCDI+ Quality) (USCDI) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Quality Core Medication)
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Who the dispense is for
... type 0..1 CodeableConcept (USCDI) Trial fill, partial fill, emergency fill, etc.
Binding: V3 Value SetActPharmacySupplyType (extensible)
... quantity 0..1 Quantity (USCDI+ Quality) (USCDI) Amount dispensed
... daysSupply 0..1 SimpleQuantity (USCDI+ Quality) Amount of medication expressed as a timing amount
... whenPrepared 0..1 dateTime When product was packaged and reviewed
... whenHandedOver 0..1 dateTime (USCDI) When product was given out or mailed
... dosageInstruction 0..* Dosage (USCDI+ Quality) (USCDI) How the medication is to be used by the patient or administered by the caregiver
.... text 0..1 string (USCDI+ Quality) (USCDI) Free text dosage instructions e.g. SIG
.... timing 0..1 Timing (USCDI+ Quality) (USCDI) When medication should be administered
.... route 0..1 CodeableConcept (USCDI+ Quality) How drug should enter body
.... doseAndRate 0..* Element (USCDI+ Quality) (USCDI) Amount of medication administered
..... dose[x] 0..1 (USCDI+ Quality) (USCDI) Amount of medication per dose
...... doseQuantity Quantity
...... doseRange Range

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Non-Negative MedicationDispense Status 📦0.5.0 This IG
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.type Base extensible V3 Value SetActPharmacySupplyType 📦2014-03-26 FHIR Std.
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* USCoreMedicationDispenseProfile(6.1.0) Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External identifier
... partOf 0..* Reference(Procedure) Event that dispense is part of
... status ?!SΣC 1..1 code (USCDI+ Quality) (USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown
Binding: Non-Negative MedicationDispense Status (required)
... statusReason[x] 0..1 Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
.... statusReasonCodeableConcept CodeableConcept
.... statusReasonReference Reference(DetectedIssue)
... category 0..1 CodeableConcept Type of medication dispense
Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
... medication[x] SΣ 1..1 (USCDI+ Quality) (USCDI) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Quality Core Medication)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the dispense is for
... context 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with event
... supportingInformation 0..* Reference(Resource) Information that supports the dispensing of the medication
... performer S 0..* BackboneElement (USCDI) Who performed event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function 0..1 CodeableConcept Who performed the dispense and what they did
Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
.... actor S 1..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) (USCDI) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription S 0..* Reference(US Quality Core MedicationRequest) (USCDI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (USCDI) Trial fill, partial fill, emergency fill, etc.
Binding: V3 Value SetActPharmacySupplyType (extensible)
... quantity S 0..1 Quantity (USCDI+ Quality) (USCDI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... daysSupply 0..1 SimpleQuantity (USCDI+ Quality) Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
... whenHandedOver SC 0..1 dateTime (USCDI) When product was given out or mailed
... destination 0..1 Reference(Location) Where the medication was sent
... receiver 0..* Reference(Patient | Practitioner) Who collected the medication
... note 0..* Annotation Information about the dispense
... dosageInstruction S 0..* Dosage (USCDI+ Quality) (USCDI) How the medication is to be used by the patient or administered by the caregiver
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string (USCDI+ Quality) (USCDI) Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣ 0..1 Timing (USCDI+ Quality) (USCDI) When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
.... route Σ 0..1 CodeableConcept (USCDI+ Quality) How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
.... doseAndRate SΣ 0..* Element (USCDI+ Quality) (USCDI) Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.
..... dose[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... substitution 0..1 BackboneElement Whether a substitution was performed on the dispense
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1 boolean Whether a substitution was or was not performed on the dispense
.... type 0..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
Binding: V3 Value SetActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
.... reason 0..* CodeableConcept Why was substitution made
Binding: V3 Value SetSubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
.... responsibleParty 0..* Reference(Practitioner | PractitionerRole) Who is responsible for the substitution
... detectedIssue 0..* Reference(DetectedIssue) Clinical issue with action
... eventHistory 0..* Reference(Provenance) A list of relevant lifecycle events

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationDispense.status Base required Non-Negative MedicationDispense Status 📦0.5.0 This IG
MedicationDispense.statusReason[x] Base example Medication dispense status reason codes 📦4.0.1 FHIR Std.
MedicationDispense.category Base preferred Medication dispense category codes 📦4.0.1 FHIR Std.
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.performer.​function Base example Medication dispense performer function codes 📦4.0.1 FHIR Std.
MedicationDispense.type Base extensible V3 Value SetActPharmacySupplyType 📦2014-03-26 FHIR Std.
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.substitution.​type Base example V3 Value SetActSubstanceAdminSubstitutionCode 📦2014-03-26 FHIR Std.
MedicationDispense.substitution.​reason Base example V3 Value SetSubstanceAdminSubstitutionReason 📦2014-03-26 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
us-core-20 error MedicationDispense whenHandedOver SHALL be present if the status is "completed" status='completed' implies whenHandedOver.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* USCoreMedicationDispenseProfile(6.1.0) Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣC 1..1 code (USCDI+ Quality) (USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown
Binding: Non-Negative MedicationDispense Status (required)
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Quality Core Medication)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the dispense is for
... performer S 0..* BackboneElement (USCDI) Who performed event
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... actor S 1..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) (USCDI) Individual who was performing
... authorizingPrescription S 0..* Reference(US Quality Core MedicationRequest) (USCDI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (USCDI) Trial fill, partial fill, emergency fill, etc.
Binding: V3 Value SetActPharmacySupplyType (extensible)
... quantity S 0..1 Quantity (USCDI+ Quality) (USCDI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... daysSupply 0..1 SimpleQuantity (USCDI+ Quality) Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
... whenHandedOver SC 0..1 dateTime (USCDI) When product was given out or mailed
... dosageInstruction S 0..* Dosage (USCDI+ Quality) (USCDI) How the medication is to be used by the patient or administered by the caregiver
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... text SΣ 0..1 string (USCDI+ Quality) (USCDI) Free text dosage instructions e.g. SIG
.... timing SΣ 0..1 Timing (USCDI+ Quality) (USCDI) When medication should be administered
.... route Σ 0..1 CodeableConcept (USCDI+ Quality) How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... doseAndRate SΣ 0..* Element (USCDI+ Quality) (USCDI) Amount of medication administered
..... dose[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Non-Negative MedicationDispense Status 📦0.5.0 This IG
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.type Base extensible V3 Value SetActPharmacySupplyType 📦2014-03-26 FHIR Std.
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
us-core-20 error MedicationDispense whenHandedOver SHALL be present if the status is "completed" status='completed' implies whenHandedOver.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense 0..* USCoreMedicationDispenseProfile(6.1.0) Dispensing a medication to a named patient
... status 1..1 code (USCDI+ Quality) (USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown
Binding: Non-Negative MedicationDispense Status (required)
... medication[x] 1..1 (USCDI+ Quality) (USCDI) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Quality Core Medication)
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Who the dispense is for
... type 0..1 CodeableConcept (USCDI) Trial fill, partial fill, emergency fill, etc.
Binding: V3 Value SetActPharmacySupplyType (extensible)
... quantity 0..1 Quantity (USCDI+ Quality) (USCDI) Amount dispensed
... daysSupply 0..1 SimpleQuantity (USCDI+ Quality) Amount of medication expressed as a timing amount
... whenPrepared 0..1 dateTime When product was packaged and reviewed
... whenHandedOver 0..1 dateTime (USCDI) When product was given out or mailed
... dosageInstruction 0..* Dosage (USCDI+ Quality) (USCDI) How the medication is to be used by the patient or administered by the caregiver
.... text 0..1 string (USCDI+ Quality) (USCDI) Free text dosage instructions e.g. SIG
.... timing 0..1 Timing (USCDI+ Quality) (USCDI) When medication should be administered
.... route 0..1 CodeableConcept (USCDI+ Quality) How drug should enter body
.... doseAndRate 0..* Element (USCDI+ Quality) (USCDI) Amount of medication administered
..... dose[x] 0..1 (USCDI+ Quality) (USCDI) Amount of medication per dose
...... doseQuantity Quantity
...... doseRange Range

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required Non-Negative MedicationDispense Status 📦0.5.0 This IG
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.type Base extensible V3 Value SetActPharmacySupplyType 📦2014-03-26 FHIR Std.

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* USCoreMedicationDispenseProfile(6.1.0) Dispensing a medication to a named patient
Constraints: mdd-1, us-core-20
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier External identifier
... partOf 0..* Reference(Procedure) Event that dispense is part of
... status ?!SΣC 1..1 code (USCDI+ Quality) (USCDI) preparation​ | in-progress​ | cancelled​ | on-hold​ | completed​ | entered-in-error​ | stopped​ | unknown
Binding: Non-Negative MedicationDispense Status (required)
... statusReason[x] 0..1 Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
.... statusReasonCodeableConcept CodeableConcept
.... statusReasonReference Reference(DetectedIssue)
... category 0..1 CodeableConcept Type of medication dispense
Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
... medication[x] SΣ 1..1 (USCDI+ Quality) (USCDI) What medication was supplied
Binding: Medication Clinical Drug . (extensible): The set of RxNorm codes to represent medications
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference(US Quality Core Medication)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the dispense is for
... context 0..1 Reference(Encounter | EpisodeOfCare) Encounter / Episode associated with event
... supportingInformation 0..* Reference(Resource) Information that supports the dispensing of the medication
... performer S 0..* BackboneElement (USCDI) Who performed event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function 0..1 CodeableConcept Who performed the dispense and what they did
Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
.... actor S 1..1 Reference(US Core Practitioner Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core Organization Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0) | Device) (USCDI) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription S 0..* Reference(US Quality Core MedicationRequest) (USCDI) Medication order that authorizes the dispense
... type S 0..1 CodeableConcept (USCDI) Trial fill, partial fill, emergency fill, etc.
Binding: V3 Value SetActPharmacySupplyType (extensible)
... quantity S 0..1 Quantity (USCDI+ Quality) (USCDI) Amount dispensed
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
... daysSupply 0..1 SimpleQuantity (USCDI+ Quality) Amount of medication expressed as a timing amount
... whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
... whenHandedOver SC 0..1 dateTime (USCDI) When product was given out or mailed
... destination 0..1 Reference(Location) Where the medication was sent
... receiver 0..* Reference(Patient | Practitioner) Who collected the medication
... note 0..* Annotation Information about the dispense
... dosageInstruction S 0..* Dosage (USCDI+ Quality) (USCDI) How the medication is to be used by the patient or administered by the caregiver
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 0..1 integer The order of the dosage instructions
.... text SΣ 0..1 string (USCDI+ Quality) (USCDI) Free text dosage instructions e.g. SIG
.... additionalInstruction Σ 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
.... patientInstruction Σ 0..1 string Patient or consumer oriented instructions
.... timing SΣ 0..1 Timing (USCDI+ Quality) (USCDI) When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site Σ 0..1 CodeableConcept Body site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
.... route Σ 0..1 CodeableConcept (USCDI+ Quality) How drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... method Σ 0..1 CodeableConcept Technique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
.... doseAndRate SΣ 0..* Element (USCDI+ Quality) (USCDI) Amount of medication administered
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ 0..1 CodeableConcept The kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.
..... dose[x] SΣ 0..1 (USCDI+ Quality) (USCDI) Amount of medication per dose
Binding: Common UCUM units (preferred)
Additional BindingsPurpose
UCUMCodes Max Binding
...... doseQuantity Quantity S
...... doseRange Range
..... rate[x] Σ 0..1 Amount of medication per unit of time
...... rateRatio Ratio
...... rateRange Range
...... rateQuantity Quantity(SimpleQuantity)
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
.... maxDosePerAdministration Σ 0..1 SimpleQuantity Upper limit on medication per administration
.... maxDosePerLifetime Σ 0..1 SimpleQuantity Upper limit on medication per lifetime of the patient
... substitution 0..1 BackboneElement Whether a substitution was performed on the dispense
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1 boolean Whether a substitution was or was not performed on the dispense
.... type 0..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
Binding: V3 Value SetActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
.... reason 0..* CodeableConcept Why was substitution made
Binding: V3 Value SetSubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
.... responsibleParty 0..* Reference(Practitioner | PractitionerRole) Who is responsible for the substitution
... detectedIssue 0..* Reference(DetectedIssue) Clinical issue with action
... eventHistory 0..* Reference(Provenance) A list of relevant lifecycle events

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.language Base preferred Common Languages 📦4.0.1 FHIR Std.
MedicationDispense.status Base required Non-Negative MedicationDispense Status 📦0.5.0 This IG
MedicationDispense.statusReason[x] Base example Medication dispense status reason codes 📦4.0.1 FHIR Std.
MedicationDispense.category Base preferred Medication dispense category codes 📦4.0.1 FHIR Std.
MedicationDispense.medication[x] Base extensible Medication Clinical Drug . 📦20170601 VSAC v0.18
MedicationDispense.performer.​function Base example Medication dispense performer function codes 📦4.0.1 FHIR Std.
MedicationDispense.type Base extensible V3 Value SetActPharmacySupplyType 📦2014-03-26 FHIR Std.
MedicationDispense.quantity Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​additionalInstruction Base example SNOMED CT Additional Dosage Instructions 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​site Base example SNOMED CT Anatomical Structure for Administration Site Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​route Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​method Base example SNOMED CT Administration Method Codes 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.type Base example DoseAndRateType 📦4.0.1 FHIR Std.
MedicationDispense.dosageInstruction.​doseAndRate.dose[x] Base preferred Common UCUM units 📦4.0.1 FHIR Std.
MedicationDispense.substitution.​type Base example V3 Value SetActSubstanceAdminSubstitutionCode 📦2014-03-26 FHIR Std.
MedicationDispense.substitution.​reason Base example V3 Value SetSubstanceAdminSubstitutionReason 📦2014-03-26 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
us-core-20 error MedicationDispense whenHandedOver SHALL be present if the status is "completed" status='completed' implies whenHandedOver.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

CQL Authoring Usage (Informational)

To create an expression specifically requesting information that a MedicationDispense intentionally did not occur for a medical, patient or system reason, use the profile USQualityCore-medicationnotdispensed.

The following example illustrates the use of the MedicationDispense profile:

define "Dementia Medication Dispensed":
  ["MedicationDispense": "Dementia Medications"] MedicationDispense
    where MedicationDispense.status in { 'active', 'completed', 'on-hold' }