HL7® FHIR® New Zealand Base Implementation Guide
3.1.0 - Release

HL7® FHIR® New Zealand Base Implementation Guide - Downloaded Version null See the Directory of published versions

## Resource Profile: NzMedicationDispense - XML Profile

Draft as of 2026-07-24

XML representation of the NzMedicationDispense resource profile.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="NzMedicationDispense"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition NzMedicationDispense</b></p><a name="NzMedicationDispense"> </a><a name="hcNzMedicationDispense"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-NzMedicationDispense-definitions.html#MedicationDispense">MedicationDispense</a><a name="MedicationDispense"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/medicationdispense.html">MedicationDispense</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Dispensing a medication to a named patient</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck03.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic; font-style: italic" href="StructureDefinition-NzMedicationDispense-definitions.html#MedicationDispense.medication[x]">Slices for medication[x]</a><a name="MedicationDispense.medication_x_"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="opacity: 0.5; font-style: italic">1</span><span style="opacity: 0.5; font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">1</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic; opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a><span style="opacity: 0.5; font-style: italic">, </span><a style="font-style: italic; font-style: italic" href="http://hl7.org/fhir/R4/references.html">Reference</a><span style="font-style: italic">(</span><a style="opacity: 0.5; font-style: italic; opacity: 0.5; font-style: italic" href="http://hl7.org/fhir/R4/medication.html">Medication</a><span style="font-style: italic">)</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">What medication was supplied</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by type:$this</span></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck024.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-NzMedicationDispense-definitions.html#MedicationDispense.medication[x]:medicationCodeableConcept" title="Slice medicationCodeableConcept">medication[x]:medicationCodeableConcept</a><a name="MedicationDispense.medication_x_:medicationCodeableConcept"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">What medication was supplied</span><br class="binding"/><span style="font-weight:bold" title="null" class="binding">Binding: </span><a href="http://nzmt.org.nz/vs" class="binding">http://nzmt.org.nz/vs</a><span title="null" class="binding"> (</span><a href="http://hl7.org/fhir/R4/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." class="binding">preferred</a><span title="null" class="binding">)</span></td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <url
           value="http://hl7.org.nz/fhir/StructureDefinition/NzMedicationDispense"/>
      <version value="1.0.0"/>
      <name value="NzMedicationDispense"/>
      <title value="Medication Dispense resource for use in NZ"/>
      <status value="draft"/>
      <date value="2026-07-24T15:52:23+12:00"/>
      <publisher value="HL7 New Zealand"/>
      <contact>
        <name value="HL7 New Zealand"/>
        <telecom>
          <system value="email"/>
          <value value="mailto:admin@hl7.org.nz"/>
        </telecom>
      </contact>
      <description value="Medication Dispense resource for use in NZ"/>
      <fhirVersion value="4.0.1"/>
      <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/MedicationDispense"/>
      <derivation value="constraint"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="4.0.1"/>
        </extension>
        <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 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()"/>
            <xpath
                   value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or 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/@value &gt;= f:whenPrepared/@value)"/>
            <source
                    value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/>
          </constraint>
          <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>
        </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>
          <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>
          <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>
          <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>
          <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>
            <strength value="preferred"/>
            <description value="A human language."/>
            <valueSet value="http://hl7.org/fhir/ValueSet/languages|4.0.1"/>
          </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>
          <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>
          <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>
          <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](http://hl7.org/fhir/R4/extensibility.html#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>
          <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>
          <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|4.0.1"/>
          </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>
          <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>
          <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="A coded concept specifying the state of the dispense event."/>
            <valueSet
                      value="http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1"/>
          </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|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="open"/>
          </slicing>
          <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|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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.medication[x]:medicationCodeableConcept">
          <path value="MedicationDispense.medication[x]"/>
          <sliceName value="medicationCodeableConcept"/>
          <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="0"/>
          <max value="1"/>
          <base>
            <path value="MedicationDispense.medication[x]"/>
            <min value="1"/>
            <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>
          <isModifier value="false"/>
          <isSummary value="true"/>
          <binding>
            <strength value="preferred"/>
            <valueSet value="http://nzmt.org.nz/vs"/>
          </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|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Group|4.0.1"/>
          </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>
          <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|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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>
          <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"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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](http://hl7.org/fhir/R4/extensibility.html#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>
          <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|4.0.1"/>
          </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|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Patient|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Device|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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>
          <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>
          <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="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc."/>
            <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|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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>
          <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>
          <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>
          <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|4.0.1"/>
          </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>
          <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|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1"/>
          </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>
          <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>
          <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>
          <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"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <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](http://hl7.org/fhir/R4/extensibility.html#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>
          <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>
          <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="A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription."/>
            <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>
          <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="A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed."/>
            <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|4.0.1"/>
            <targetProfile
                           value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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>
          <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|4.0.1"/>
          </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>
          <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"/>
        </element>
        <element id="MedicationDispense.medication[x]">
          <path value="MedicationDispense.medication[x]"/>
          <slicing>
            <discriminator>
              <type value="type"/>
              <path value="$this"/>
            </discriminator>
            <ordered value="false"/>
            <rules value="open"/>
          </slicing>
        </element>
        <element id="MedicationDispense.medication[x]:medicationCodeableConcept">
          <path value="MedicationDispense.medication[x]"/>
          <sliceName value="medicationCodeableConcept"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
          <binding>
            <strength value="preferred"/>
            <valueSet value="http://nzmt.org.nz/vs"/>
          </binding>
        </element>
      </differential>
    </StructureDefinition>