<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="v3-substanceAdminSubstitution" />
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>The narrative has been removed to reduce the size of the distribution of the Hl7.Fhir.Specification library</p>
    </div>
  </text>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status">
    <valueString value="External" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="0" />
  </extension>
  <url value="http://hl7.org/fhir/v3/substanceAdminSubstitution" />
  <identifier>
    <system value="urn:ietf:rfc:3986" />
    <value value="urn:oid:2.16.840.1.113883.5.1070" />
  </identifier>
  <version value="2016-11-11" />
  <name value="v3 Code System substanceAdminSubstitution" />
  <status value="active" />
  <experimental value="false" />
  <date value="2016-11-11T00:00:00+00:00" />
  <publisher value="HL7, Inc" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://hl7.org" />
    </telecom>
  </contact>
  <description value=" Identifies what sort of change is permitted or has occurred between the therapy that was ordered and the therapy that was/will be provided." />
  <caseSensitive value="true" />
  <valueSet value="http://hl7.org/fhir/ValueSet/v3-substanceAdminSubstitution" />
  <hierarchyMeaning value="is-a" />
  <content value="complete" />
  <property>
    <code value="notSelectable" />
    <uri value="http://hl7.org/fhir/concept-properties#notSelectable" />
    <description value="Indicates that the code is abstract - only intended to be used as a selector for other concepts" />
    <type value="boolean" />
  </property>
  <concept>
    <code value="_ActSubstanceAdminSubstitutionCode" />
    <display value="ActSubstanceAdminSubstitutionCode" />
    <definition value="Description: Substitution occurred or is permitted with another product that may potentially have different ingredients, but having the same biological and therapeutic effects." />
    <property>
      <code value="notSelectable" />
      <valueBoolean value="true" />
    </property>
    <concept>
      <code value="E" />
      <display value="equivalent" />
      <definition value="Description: Substitution occurred or is permitted with another bioequivalent and therapeutically equivalent product." />
      <concept>
        <code value="EC" />
        <display value="equivalent composition" />
        <definition value="Description: &#xA;                        &#xD;&#xA;&#xA;                        Substitution occurred or is permitted with another product that is a:&#xD;&#xA;&#xA;                        &#xA;                           pharmaceutical alternative containing the same active ingredient but is formulated with different salt, ester&#xA;                           pharmaceutical equivalent that has the same active ingredient, strength, dosage form and route of administration&#xA;                        &#xA;                        &#xA;                           Examples: &#xA;                        &#xD;&#xA;&#xA;                        &#xA;                           &#xA;                              Pharmaceutical alternative: Erythromycin Ethylsuccinate for Erythromycin Stearate&#xA;                           &#xA;                              Pharmaceutical equivalent: Lisonpril for Zestril" />
        <concept>
          <code value="BC" />
          <display value="brand composition" />
          <definition value="Description: &#xA;                        &#xD;&#xA;&#xA;                        Substitution occurred or is permitted between equivalent Brands but not Generics&#xD;&#xA;&#xA;                        &#xA;                           Examples: &#xA;                        &#xD;&#xA;&#xA;                        &#xA;                           Zestril  for Prinivil&#xA;                           Coumadin for Jantoven" />
        </concept>
        <concept>
          <code value="G" />
          <display value="generic composition" />
          <definition value="Description: Substitution occurred or is permitted between equivalent Generics but not Brands&#xD;&#xA;&#xA;                        &#xA;                           Examples: &#xA;                        &#xD;&#xA;&#xA;                        &#xA;                           Lisnopril (Lupin Corp) for Lisnopril (Wockhardt Corp)" />
        </concept>
      </concept>
      <concept>
        <code value="TE" />
        <display value="therapeutic alternative" />
        <definition value="Description: Substitution occurred or is permitted with another product having the same therapeutic objective and safety profile.&#xD;&#xA;&#xA;                        &#xA;                           Examples: &#xA;                        &#xD;&#xA;&#xA;                        &#xA;                           ranitidine for Tagamet" />
        <concept>
          <code value="TB" />
          <display value="therapeutic brand" />
          <definition value="Description: Substitution occurred or is permitted between therapeutically equivalent Brands but not Generics&#xD;&#xA;&gt;&#xA;                           Examples: &#xA;                        &#xD;&#xA;&#xA;                        &#xA;                           Zantac for Tagamet" />
        </concept>
        <concept>
          <code value="TG" />
          <display value="therapeutic generic" />
          <definition value="Description: Substitution occurred or is permitted between therapeutically equivalent Generics but not Brands&#xD;&#xA;&gt;&#xA;                           Examples: &#xA;                        &#xD;&#xA;&#xA;                        &#xA;                           Ranitidine  for cimetidine" />
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="F" />
      <display value="formulary" />
      <definition value="Description: This substitution was performed or is permitted based on formulary guidelines." />
    </concept>
    <concept>
      <code value="N" />
      <display value="none" />
      <definition value="No substitution occurred or is permitted." />
    </concept>
  </concept>
</CodeSystem>