Save Sight Registries Implementation Guide

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SSRPreTreatment

SSRPreTreatment (MedicationStatement)	I		MedicationStatement	Element id MedicationStatement Short description Record of medication being taken by a patient Definition A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information. Comments When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error. Data type MedicationStatement Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() ssr-pretreat-1: If medication is "Aflibercept" then SHALL have a value for dosage.doseAndRate.doseQuantity.value `medicationCodeableConcept.coding.where(system='http://snomed.info.sct' and code = '703840003').count() = 0 or dosage.doseAndRate.doseQuantity.value.exists()` Mappings rim: Entity. Role, or Act workflow: Event rim: SubstanceAdministration
id	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationStatement.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationStatement.implicitRules Short description A set of rules under which this content was created Definition 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. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id MedicationStatement.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments 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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationStatement.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition 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. Comments 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. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition 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). Requirements 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id MedicationStatement.identifier Short description External identifier Definition Identifiers associated with this Medication Statement 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. Comments This is a business identifier, not a resource identifier. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier rim: .id
basedOn	Σ	0..*	Reference(MedicationRequest \| CarePlan \| ServiceRequest)	There are no (further) constraints on this element Element id MedicationStatement.basedOn Short description Fulfils plan, proposal or order Definition A plan, proposal or order that is fulfilled in whole or in part by this event. Requirements Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. Data type Reference(MedicationRequest \| CarePlan \| ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
partOf	Σ	0..*	Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation)	There are no (further) constraints on this element Element id MedicationStatement.partOf Short description Part of referenced event Definition A larger event of which this particular event is a component or step. Requirements This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used. Data type Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf rim: .outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.status Short description active \| completed \| entered-in-error \| intended \| stopped \| on-hold \| unknown \| not-taken Definition A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed. Comments MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error). This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A coded concept indicating the current status of a MedicationStatement. Medication Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.status w5: FiveWs.status rim: .statusCode
statusReason		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.statusReason Short description Reason for current status Definition Captures the reason for the current state of the MedicationStatement. Comments This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here. Data type CodeableConcept Binding A coded concept indicating the reason for the status of the statement. SNOMEDCTDrugTherapyStatusCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
category	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationStatement.category Short description Type of medication usage Definition Indicates where the medication is expected to be consumed or administered. Data type CodeableConcept Binding A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered. Medication usage category codes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
medication[x]	Σ	1..1	Binding	Element id MedicationStatement.medication[x] Short description What medication was taken Definition 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. Comments 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. Binding A coded concept identifying the substance or product being taken. ssr-pretreatments (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.code w5: FiveWs.what[x] rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.medication[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uri	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationStatement.medication[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.medication[x].text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subject	Σ	1..1	Reference(SSRPatient)	Element id MedicationStatement.subject Short description Who is/was taking the medication Definition The person, animal or group who is/was taking the medication. Data type Reference(SSRPatient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: FiveWs.subject
context	Σ	0..1	Reference(SSREncounter)	Element id MedicationStatement.context Short description Encounter / Episode associated with MedicationStatement Definition The encounter or episode of care that establishes the context for this MedicationStatement. Data type Reference(SSREncounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
effective[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.effective[x] Short description The date/time or interval when the medication is/was/will be taken Definition The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No). Comments This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] w5: FiveWs.done[x] rim: .effectiveTime
effectiveDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
effectivePeriod			Period	There are no (further) constraints on this element Data type Period
dateAsserted	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationStatement.dateAsserted Short description When the statement was asserted? Definition The date when the medication statement was asserted by the information source. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
informationSource		0..1	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)	There are no (further) constraints on this element Element id MedicationStatement.informationSource Short description Person or organization that provided the information about the taking of this medication Definition The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest. Data type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.source rim: .participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)
derivedFrom		0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationStatement.derivedFrom Short description Additional supporting information Definition Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. Comments Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]
reasonCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.reasonCode Short description Reason for why the medication is being/was taken Definition A reason for why the medication is being/was taken. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. Data type CodeableConcept Binding A coded concept identifying why the medication is being taken. Condition/Problem/DiagnosisCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonCode w5: FiveWs.why[x] rim: .reasonCode
reasonReference		0..*	Reference(Condition \| Observation \| DiagnosticReport)	There are no (further) constraints on this element Element id MedicationStatement.reasonReference Short description Condition or observation that supports why the medication is being/was taken Definition Condition or observation that supports why the medication is being/was taken. Comments This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode. Data type Reference(Condition \| Observation \| DiagnosticReport) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference w5: FiveWs.why[x] rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value
note		0..*	Annotation	There are no (further) constraints on this element Element id MedicationStatement.note Short description Further information about the statement Definition Provides extra information about the medication statement that is not conveyed by the other attributes. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
dosage		1..*	Dosage	There are no (further) constraints on this element Element id MedicationStatement.dosage Short description Details of how medication is/was taken or should be taken Definition Indicates how the medication is/was or should be taken by the patient. Comments The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest. Data type Dosage Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: refer dosageInstruction mapping
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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). Requirements 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
sequence	Σ	0..1	integer	There are no (further) constraints on this element Element id MedicationStatement.dosage.sequence Short description The order of the dosage instructions Definition Indicates the order in which the dosage instructions should be applied or interpreted. Requirements If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: TQ1-1 rim: .text
text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.text Short description Free text dosage instructions e.g. SIG Definition Free text dosage instructions e.g. SIG. Requirements Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-6; RXE-21 rim: .text
additionalInstruction	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.additionalInstruction Short description Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Definition Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). Requirements Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Comments Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. Data type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-7 rim: .text
patientInstruction	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.patientInstruction Short description Patient or consumer oriented instructions Definition Instructions in terms that are understood by the patient or consumer. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-7 rim: .text
timing	Σ	0..1	Timing	There are no (further) constraints on this element Element id MedicationStatement.dosage.timing Short description When medication should be administered Definition When medication should be administered. Requirements The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. Data type Timing Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
asNeeded[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.dosage.asNeeded[x] Short description Take "as needed" (for x) Definition Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Comments Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". Binding A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMEDCTMedicationAsNeededReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: TQ1-9 rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
asNeededBoolean			boolean	There are no (further) constraints on this element Data type boolean
asNeededCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
site	Σ	1..1	CodeableConceptBinding	Element id MedicationStatement.dosage.site Short description Body site to administer to Definition Body site to administer to. Requirements A coded specification of the anatomic site where the medication first enters the body. Comments If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. Data type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. ssr-eye-body-site (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-2 rim: .approachSiteCode
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
system	Σ	1..1	uri	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
route	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.route Short description How drug should enter body Definition How drug should enter body. Requirements A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Data type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-1 rim: .routeCode
method	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.method Short description Technique for administering medication Definition Technique for administering medication. Requirements A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Comments Terminologies used often pre-coordinate this term with the route and or form of administration. Data type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXR-4 rim: .doseQuantity
doseAndRate	Σ	0..*	Element	There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate Short description Amount of medication administered Definition The amount of medication administered. Data type Element Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: TQ1-2
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". Data type CodeableConcept Binding The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-21; RXE-23
dose[x]	Σ I	1..1		There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.dose[x] Short description Amount of medication per dose Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-2, RXE-3 rim: .doseQuantity
doseQuantity			SimpleQuantity	Data type SimpleQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.dose[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.dose[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
value	Σ	1..1	decimal	Element id MedicationStatement.dosage.doseAndRate.dose[x].value Short description 2 \| 8 Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.dose[x].comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	stringFixed Value	Element id MedicationStatement.dosage.doseAndRate.dose[x].unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value mg Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uriFixed Value	Element id MedicationStatement.dosage.doseAndRate.dose[x].system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://unitsofmeasure.org Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	codeFixed Value	Element id MedicationStatement.dosage.doseAndRate.dose[x].code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value mg Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
rate[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationStatement.dosage.doseAndRate.rate[x] Short description Amount of medication per unit of time Definition Amount of medication per unit of time. Requirements Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. Comments It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXE22, RXE23, RXE-24 rim: .rateQuantity
rateRatio			Ratio	There are no (further) constraints on this element Data type Ratio
rateRange			Range	There are no (further) constraints on this element Data type Range
rateQuantity			SimpleQuantity	There are no (further) constraints on this element Data type SimpleQuantity
maxDosePerPeriod	Σ	0..1	Ratio	There are no (further) constraints on this element Element id MedicationStatement.dosage.maxDosePerPeriod Short description Upper limit on medication per unit of time Definition Upper limit on medication per unit of time. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". Data type Ratio Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: RXO-23, RXE-19 rim: .maxDoseQuantity
maxDosePerAdministration	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationStatement.dosage.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration. Requirements The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. Comments This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: not supported
maxDosePerLifetime	Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationStatement.dosage.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient. Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: not supported

{
    "resourceType": "StructureDefinition",
    "url": "https://frbresearch.org/fhir/StructureDefinition/SSRPreTreatment",
    "name": "SSRPreTreatment",
    "title": "SSR Pre Treatment",
    "status": "draft",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "MedicationStatement",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
    "derivation": "constraint",
    "snapshot": {
        "element":  [
            {
                "id": "MedicationStatement",
                "path": "MedicationStatement",
                "short": "Record of medication being taken by a patient",
                "definition": "A record of a medication that is being consumed by a patient.   A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future.  The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician.  A common scenario where this information is captured is during the history taking process during a patient visit or stay.   The medication information may come from sources such as the patient's memory, from a prescription bottle,  or from a list of medications the patient, clinician or other party maintains. \n\nThe primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication.  A medication statement is often, if not always, less specific.  There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise.  As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains.  Medication administration is more formal and is not missing detailed information.",
                "comment": "When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\nMedicationStatement.status + MedicationStatement.wasNotTaken\nStatus=Active + NotTaken=T = Not currently taking\nStatus=Completed + NotTaken=T = Not taken in the past\nStatus=Intended + NotTaken=T = No intention of taking\nStatus=Active + NotTaken=F = Taking, but not as prescribed\nStatus=Active + NotTaken=F = Taking\nStatus=Intended +NotTaken= F = Will be taking (not started)\nStatus=Completed + NotTaken=F = Taken in past\nStatus=In Error + NotTaken=N/A = In Error.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement",
                    "min": 0,
                    "max": "*"
                },
                "constraint":  [
                    {
                        "key": "dom-2",
                        "severity": "error",
                        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
                        "expression": "contained.contained.empty()",
                        "xpath": "not(parent::f:contained and f:contained)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-4",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
                        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-3",
                        "severity": "error",
                        "human": "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": "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": "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": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                                "valueBoolean": true
                            },
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                                "valueMarkdown": "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."
                            }
                        ],
                        "key": "dom-6",
                        "severity": "warning",
                        "human": "A resource should have narrative for robust management",
                        "expression": "text.`div`.exists()",
                        "xpath": "exists(f:text/h:div)",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "dom-5",
                        "severity": "error",
                        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
                        "expression": "contained.meta.security.empty()",
                        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
                        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
                    },
                    {
                        "key": "ssr-pretreat-1",
                        "severity": "error",
                        "human": "If medication is \"Aflibercept\" then SHALL have a value for dosage.doseAndRate.doseQuantity.value",
                        "expression": "medicationCodeableConcept.coding.where(system='http://snomed.info.sct' and code = '703840003').count() = 0 or dosage.doseAndRate.doseQuantity.value.exists()",
                        "source": "https://frbresearch.org/fhir/StructureDefinition/SSRPreTreatment"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event"
                    },
                    {
                        "identity": "rim",
                        "map": "SubstanceAdministration"
                    }
                ]
            },
            {
                "id": "MedicationStatement.id",
                "path": "MedicationStatement.id",
                "short": "Logical id of this artifact",
                "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
                "comment": "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": 0,
                "max": "1",
                "base": {
                    "path": "Resource.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "isSummary": true
            },
            {
                "id": "MedicationStatement.meta",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.meta",
                "short": "Metadata about the resource",
                "definition": "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": 0,
                "max": "1",
                "base": {
                    "path": "Resource.meta",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Meta"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.implicitRules",
                "path": "MedicationStatement.implicitRules",
                "short": "A set of rules under which this content was created",
                "definition": "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": "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": 0,
                "max": "1",
                "base": {
                    "path": "Resource.implicitRules",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "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": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.language",
                "path": "MedicationStatement.language",
                "short": "Language of the resource content",
                "definition": "The base language in which the resource is written.",
                "comment": "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": 0,
                "max": "1",
                "base": {
                    "path": "Resource.language",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
                            "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "Language"
                        },
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
                            "valueBoolean": true
                        }
                    ],
                    "strength": "preferred",
                    "description": "A human language.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/languages"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.text",
                "short": "Text summary of the resource, for human interpretation",
                "definition": "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 \"clinically safe\" 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": "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 \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
                "alias":  [
                    "narrative",
                    "html",
                    "xhtml",
                    "display"
                ],
                "min": 0,
                "max": "1",
                "base": {
                    "path": "DomainResource.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Narrative"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act.text?"
                    }
                ]
            },
            {
                "id": "MedicationStatement.contained",
                "path": "MedicationStatement.contained",
                "short": "Contained, inline Resources",
                "definition": "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": "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":  [
                    "inline resources",
                    "anonymous resources",
                    "contained resources"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.contained",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Resource"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "Entity. Role, or Act"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.modifierExtension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.modifierExtension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Extensions that cannot be ignored",
                "definition": "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "DomainResource.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.identifier",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.identifier",
                "short": "External identifier",
                "definition": "Identifiers associated with this Medication Statement 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": "This is a business identifier, not a resource identifier.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.identifier",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Identifier"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
                    },
                    {
                        "identity": "rim",
                        "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"
                    },
                    {
                        "identity": "servd",
                        "map": "Identifier"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.identifier"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.identifier"
                    },
                    {
                        "identity": "rim",
                        "map": ".id"
                    }
                ]
            },
            {
                "id": "MedicationStatement.basedOn",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.basedOn",
                "short": "Fulfils plan, proposal or order",
                "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.basedOn",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/MedicationRequest",
                            "http://hl7.org/fhir/StructureDefinition/CarePlan",
                            "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.basedOn"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]"
                    }
                ]
            },
            {
                "id": "MedicationStatement.partOf",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.partOf",
                "short": "Part of referenced event",
                "definition": "A larger event of which this particular event is a component or step.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "requirements": "This should not be used when indicating which resource a MedicationStatement has been derived from.  If that is the use case, then MedicationStatement.derivedFrom should be used.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.partOf",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/MedicationAdministration",
                            "http://hl7.org/fhir/StructureDefinition/MedicationDispense",
                            "http://hl7.org/fhir/StructureDefinition/MedicationStatement",
                            "http://hl7.org/fhir/StructureDefinition/Procedure",
                            "http://hl7.org/fhir/StructureDefinition/Observation"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.partOf"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "MedicationStatement.status",
                "path": "MedicationStatement.status",
                "short": "active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken",
                "definition": "A code representing the patient or other source's judgment about the state of the medication used that this statement is about.  Generally, this will be active or completed.",
                "comment": "MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.status",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "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": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationStatementStatus"
                        }
                    ],
                    "strength": "required",
                    "description": "A coded concept indicating the current status of a MedicationStatement.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.status"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.status"
                    },
                    {
                        "identity": "rim",
                        "map": ".statusCode"
                    }
                ]
            },
            {
                "id": "MedicationStatement.statusReason",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.statusReason",
                "short": "Reason for current status",
                "definition": "Captures the reason for the current state of the MedicationStatement.",
                "comment": "This is generally only used for \"exception\" statuses such as \"not-taken\", \"on-hold\", \"cancelled\" or \"entered-in-error\". The reason for performing the event at all is captured in reasonCode, not here.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.statusReason",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationStatementStatusReason"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept indicating the reason for the status of the statement.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/reason-medication-status-codes"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.statusReason"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde"
                    }
                ]
            },
            {
                "id": "MedicationStatement.category",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.category",
                "short": "Type of medication usage",
                "definition": "Indicates where the medication is expected to be consumed or administered.",
                "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.category",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationStatementCategory"
                        }
                    ],
                    "strength": "preferred",
                    "description": "A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/medication-statement-category"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.class"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication usage\"].value"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.medication[x]",
                "short": "What medication was taken",
                "definition": "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": "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": 1,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.medication[x]",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationCode"
                        }
                    ],
                    "strength": "required",
                    "description": "A coded concept identifying the substance or product being taken.",
                    "valueSet": "https://frbresearch.org/fhir/ValueSet/ssr-pretreatments"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.code"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.what[x]"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=CSM].role[classCode=ADMM or MANU]"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].id",
                "path": "MedicationStatement.medication[x].id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.medication[x].extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.medication[x].coding",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
                "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
                "min": 1,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding.id",
                "path": "MedicationStatement.medication[x].coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.medication[x].coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding.system",
                "path": "MedicationStatement.medication[x].coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding.version",
                "path": "MedicationStatement.medication[x].coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding.code",
                "path": "MedicationStatement.medication[x].coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "MedicationStatement.medication[x].coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].coding.userSelected",
                "path": "MedicationStatement.medication[x].coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x].text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "MedicationStatement.medication[x].text",
                "short": "Plain text representation of the concept",
                "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "MedicationStatement.subject",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.subject",
                "short": "Who is/was taking  the medication",
                "definition": "The person, animal or group who is/was taking the medication.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.subject",
                    "min": 1,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://frbresearch.org/fhir/StructureDefinition/SSRPatient"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.subject"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject[x]"
                    },
                    {
                        "identity": "v2",
                        "map": "PID-3-Patient ID List"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=SBJ].role[classCode=PAT]"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.subject"
                    }
                ]
            },
            {
                "id": "MedicationStatement.context",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.context",
                "short": "Encounter / Episode associated with MedicationStatement",
                "definition": "The encounter or episode of care that establishes the context for this MedicationStatement.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.context",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://frbresearch.org/fhir/StructureDefinition/SSREncounter"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.context"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]"
                    }
                ]
            },
            {
                "id": "MedicationStatement.effective[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.effective[x]",
                "short": "The date/time or interval when the medication is/was/will be taken",
                "definition": "The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).",
                "comment": "This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the \"end\" date will be omitted.  The date/time attribute supports a variety of dates - year, year/month and exact date.  If something more than this is required, this should be conveyed as text.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.effective[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    },
                    {
                        "code": "Period"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.occurrence[x]"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.done[x]"
                    },
                    {
                        "identity": "rim",
                        "map": ".effectiveTime"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dateAsserted",
                "path": "MedicationStatement.dateAsserted",
                "short": "When the statement was asserted?",
                "definition": "The date when the medication statement was asserted by the information source.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.dateAsserted",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "dateTime"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.recorded"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=AUT].time"
                    }
                ]
            },
            {
                "id": "MedicationStatement.informationSource",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.informationSource",
                "short": "Person or organization that provided the information about the taking of this medication",
                "definition": "The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.",
                "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "MedicationStatement.informationSource",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient",
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
                            "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
                            "http://hl7.org/fhir/StructureDefinition/Organization"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.source"
                    },
                    {
                        "identity": "rim",
                        "map": ".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)"
                    }
                ]
            },
            {
                "id": "MedicationStatement.derivedFrom",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.derivedFrom",
                "short": "Additional supporting information",
                "definition": "Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.",
                "comment": "Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.  The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim.  it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.derivedFrom",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Resource"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]"
                    }
                ]
            },
            {
                "id": "MedicationStatement.reasonCode",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.reasonCode",
                "short": "Reason for why the medication is being/was taken",
                "definition": "A reason for why the medication is being/was taken.",
                "comment": "This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.reasonCode",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationReason"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept identifying why the medication is being taken.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/condition-code"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.reasonCode"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.why[x]"
                    },
                    {
                        "identity": "rim",
                        "map": ".reasonCode"
                    }
                ]
            },
            {
                "id": "MedicationStatement.reasonReference",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.reasonReference",
                "short": "Condition or observation that supports why the medication is being/was taken",
                "definition": "Condition or observation that supports why the medication is being/was taken.",
                "comment": "This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.reasonReference",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Condition",
                            "http://hl7.org/fhir/StructureDefinition/Observation",
                            "http://hl7.org/fhir/StructureDefinition/DiagnosticReport"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ref-1",
                        "severity": "error",
                        "human": "SHALL have a contained resource if a local reference is provided",
                        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
                        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Reference"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.reasonReference"
                    },
                    {
                        "identity": "w5",
                        "map": "FiveWs.why[x]"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"reason for use\"].value"
                    }
                ]
            },
            {
                "id": "MedicationStatement.note",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.note",
                "short": "Further information about the statement",
                "definition": "Provides extra information about the medication statement that is not conveyed by the other attributes.",
                "comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.note",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Annotation"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "Act"
                    },
                    {
                        "identity": "workflow",
                        "map": "Event.note"
                    },
                    {
                        "identity": "rim",
                        "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=\"annotation\"].value"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "trial-use"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage",
                "short": "Details of how medication is/was taken or should be taken",
                "definition": "Indicates how the medication is/was or should be taken by the patient.",
                "comment": "The dates included in the dosage on a Medication Statement reflect the dates for a given dose.  For example, \"from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.\"  It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.",
                "min": 1,
                "max": "*",
                "base": {
                    "path": "MedicationStatement.dosage",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Dosage"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"
                    },
                    {
                        "identity": "rim",
                        "map": "refer dosageInstruction mapping"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.id",
                "path": "MedicationStatement.dosage.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.modifierExtension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.modifierExtension",
                "short": "Extensions that cannot be ignored even if unrecognized",
                "definition": "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
                "comment": "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": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
                "alias":  [
                    "extensions",
                    "user content",
                    "modifiers"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "BackboneElement.modifierExtension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.sequence",
                "path": "MedicationStatement.dosage.sequence",
                "short": "The order of the dosage instructions",
                "definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
                "comment": "32 bit number; for values larger than this, use decimal",
                "requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.sequence",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "integer"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "TQ1-1"
                    },
                    {
                        "identity": "rim",
                        "map": ".text"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.text",
                "path": "MedicationStatement.dosage.text",
                "short": "Free text dosage instructions e.g. SIG",
                "definition": "Free text dosage instructions e.g. SIG.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.  Additional information about administration or preparation of the medication should be included as text.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "RXO-6; RXE-21"
                    },
                    {
                        "identity": "rim",
                        "map": ".text"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.additionalInstruction",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.additionalInstruction",
                "short": "Supplemental instruction or warnings to the patient - e.g. \"with meals\", \"may cause drowsiness\"",
                "definition": "Supplemental instructions to the patient on how to take the medication  (e.g. \"with meals\" or\"take half to one hour before food\") or warnings for the patient about the medication (e.g. \"may cause drowsiness\" or \"avoid exposure of skin to direct sunlight or sunlamps\").",
                "comment": "Information about administration or preparation of the medication (e.g. \"infuse as rapidly as possibly via intraperitoneal port\" or \"immediately following drug x\") should be populated in dosage.text.",
                "requirements": "Additional instruction is intended to be coded, but where no code exists, the element could include text.  For example, \"Swallow with plenty of water\" which might or might not be coded.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Dosage.additionalInstruction",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "AdditionalInstruction"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\".",
                    "valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "RXO-7"
                    },
                    {
                        "identity": "rim",
                        "map": ".text"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.patientInstruction",
                "path": "MedicationStatement.dosage.patientInstruction",
                "short": "Patient or consumer oriented instructions",
                "definition": "Instructions in terms that are understood by the patient or consumer.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.patientInstruction",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "RXO-7"
                    },
                    {
                        "identity": "rim",
                        "map": ".text"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.timing",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.timing",
                "short": "When medication should be administered",
                "definition": "When medication should be administered.",
                "comment": "This attribute might not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
                "requirements": "The timing schedule for giving the medication to the patient. This  data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\".  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.timing",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Timing"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "QSET<TS> (GTS)"
                    },
                    {
                        "identity": "rim",
                        "map": ".effectiveTime"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.asNeeded[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.asNeeded[x]",
                "short": "Take \"as needed\" (for x)",
                "definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
                "comment": "Can express \"as needed\" without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express \"as needed\" with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.asNeeded[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    },
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationAsNeededReason"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "TQ1-9"
                    },
                    {
                        "identity": "rim",
                        "map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.site",
                "short": "Body site to administer to",
                "definition": "Body site to administer to.",
                "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both.",
                "requirements": "A coded specification of the anatomic site where the medication first enters the body.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Dosage.site",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationAdministrationSite"
                        }
                    ],
                    "strength": "required",
                    "description": "A coded concept describing the site location the medicine enters into or onto the body.",
                    "valueSet": "https://frbresearch.org/fhir/ValueSet/ssr-eye-body-site"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "RXR-2"
                    },
                    {
                        "identity": "rim",
                        "map": ".approachSiteCode"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.id",
                "path": "MedicationStatement.dosage.site.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.site.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.site.coding",
                "short": "Code defined by a terminology system",
                "definition": "A reference to a code defined by a terminology system.",
                "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
                "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
                "min": 1,
                "max": "*",
                "base": {
                    "path": "CodeableConcept.coding",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Coding"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"
                    },
                    {
                        "identity": "rim",
                        "map": "CV"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1-8, C*E.10-22"
                    },
                    {
                        "identity": "rim",
                        "map": "union(., ./translation)"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding.id",
                "path": "MedicationStatement.dosage.site.coding.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.site.coding.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding.system",
                "path": "MedicationStatement.dosage.site.coding.system",
                "short": "Identity of the terminology system",
                "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
                "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
                "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.3"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystem"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding.version",
                "path": "MedicationStatement.dosage.site.coding.version",
                "short": "Version of the system - if relevant",
                "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
                "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.version",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.7"
                    },
                    {
                        "identity": "rim",
                        "map": "./codeSystemVersion"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding.code",
                "path": "MedicationStatement.dosage.site.coding.code",
                "short": "Symbol in syntax defined by the system",
                "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Need to refer to a particular code in the system.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Coding.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.1"
                    },
                    {
                        "identity": "rim",
                        "map": "./code"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding.display",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "MedicationStatement.dosage.site.coding.display",
                "short": "Representation defined by the system",
                "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.display",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.2 - but note this is not well followed"
                    },
                    {
                        "identity": "rim",
                        "map": "CV.displayName"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.coding.userSelected",
                "path": "MedicationStatement.dosage.site.coding.userSelected",
                "short": "If this coding was chosen directly by the user",
                "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
                "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
                "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Coding.userSelected",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "boolean"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "Sometimes implied by being first"
                    },
                    {
                        "identity": "rim",
                        "map": "CD.codingRationale"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.site.text",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "MedicationStatement.dosage.site.text",
                "short": "Plain text representation of the concept",
                "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
                "comment": "Very often the text is the same as a displayName of one of the codings.",
                "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "CodeableConcept.text",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "C*E.9. But note many systems use C*E.2 for this"
                    },
                    {
                        "identity": "rim",
                        "map": "./originalText[mediaType/code=\"text/plain\"]/data"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.route",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.route",
                "short": "How drug should enter body",
                "definition": "How drug should enter body.",
                "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
                "requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.route",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "RouteOfAdministration"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/route-codes"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "RXR-1"
                    },
                    {
                        "identity": "rim",
                        "map": ".routeCode"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.method",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.method",
                "short": "Technique for administering medication",
                "definition": "Technique for administering medication.",
                "comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
                "requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.method",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "MedicationAdministrationMethod"
                        }
                    ],
                    "strength": "example",
                    "description": "A coded concept describing the technique by which the medicine is administered.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/administration-method-codes"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "RXR-4"
                    },
                    {
                        "identity": "rim",
                        "map": ".doseQuantity"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.doseAndRate",
                "short": "Amount of medication administered",
                "definition": "The amount of medication administered.",
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Dosage.doseAndRate",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Element"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "TQ1-2"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.id",
                "path": "MedicationStatement.dosage.doseAndRate.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.doseAndRate.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.type",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.doseAndRate.type",
                "short": "The kind of dose or rate specified",
                "definition": "The kind of dose or rate specified, for example, ordered or calculated.",
                "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
                "requirements": "If the type is not populated, assume to be \"ordered\".",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.doseAndRate.type",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "DoseAndRateType"
                        }
                    ],
                    "strength": "example",
                    "description": "The kind of dose or rate specified.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/dose-rate-type"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "CE/CNE/CWE"
                    },
                    {
                        "identity": "rim",
                        "map": "CD"
                    },
                    {
                        "identity": "orim",
                        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
                    },
                    {
                        "identity": "v2",
                        "map": "RXO-21; RXE-23"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.doseAndRate.dose[x]",
                "short": "Amount of medication per dose",
                "definition": "Amount of medication per dose.",
                "comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
                "requirements": "The amount of therapeutic or other substance given at one administration event.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Dosage.doseAndRate.dose[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1",
                    "ssr-pretreat-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "RXO-2, RXE-3"
                    },
                    {
                        "identity": "rim",
                        "map": ".doseQuantity"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].id",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].value",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].value",
                "short": "2 | 8",
                "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
                "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
                "requirements": "Precision is handled implicitly in almost all cases of measurement.",
                "min": 1,
                "max": "1",
                "base": {
                    "path": "Quantity.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "decimal"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN.2  / CQ - N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].comparator",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].comparator",
                "short": "< | <= | >= | > - how to understand the value",
                "definition": "Not allowed to be used in this context",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Quantity.comparator",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "QuantityComparator"
                        }
                    ],
                    "strength": "required",
                    "description": "How the Quantity should be understood and represented.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN.1  / CQ.1"
                    },
                    {
                        "identity": "rim",
                        "map": "IVL properties"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].unit",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].unit",
                "short": "Unit representation",
                "definition": "A human-readable form of the unit.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.unit",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "fixedString": "mg",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.unit"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].system",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].system",
                "short": "System that defines coded unit form",
                "definition": "The identification of the system that provides the coded form of the unit.",
                "comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier",
                "requirements": "Need to know the system that defines the coded form of the unit.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "fixedUri": "http://unitsofmeasure.org",
                "condition":  [
                    "ele-1",
                    "qty-3"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "CO.codeSystem, PQ.translation.codeSystem"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].code",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].code",
                "short": "Coded form of the unit",
                "definition": "A computer processable form of the unit in some unit representation system.",
                "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
                "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "fixedCode": "mg",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.code, MO.currency, PQ.translation.code"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.rate[x]",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.doseAndRate.rate[x]",
                "short": "Amount of medication per unit of time",
                "definition": "Amount of medication per unit of time.",
                "comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.\n\nIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity.  The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator.  Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.",
                "requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.doseAndRate.rate[x]",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Ratio"
                    },
                    {
                        "code": "Range"
                    },
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "RXE22, RXE23, RXE-24"
                    },
                    {
                        "identity": "rim",
                        "map": ".rateQuantity"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerPeriod",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.maxDosePerPeriod",
                "short": "Upper limit on medication per unit of time",
                "definition": "Upper limit on medication per unit of time.",
                "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example \"2 tablets every 4 hours to a maximum of 8/day\".",
                "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.maxDosePerPeriod",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Ratio"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "rat-1",
                        "severity": "error",
                        "human": "Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present",
                        "expression": "(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())",
                        "xpath": "(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))",
                        "source": "http://hl7.org/fhir/StructureDefinition/Ratio"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "RTO"
                    },
                    {
                        "identity": "v2",
                        "map": "RXO-23, RXE-19"
                    },
                    {
                        "identity": "rim",
                        "map": ".maxDoseQuantity"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.maxDosePerAdministration",
                "short": "Upper limit on medication per administration",
                "definition": "Upper limit on medication per administration.",
                "comment": "This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
                "requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.maxDosePerAdministration",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "qty-3",
                        "severity": "error",
                        "human": "If a code for the unit is present, the system SHALL also be present",
                        "expression": "code.empty() or system.exists()",
                        "xpath": "not(exists(f:code)) or exists(f:system)",
                        "source": "http://hl7.org/fhir/StructureDefinition/Quantity"
                    },
                    {
                        "key": "sqty-1",
                        "severity": "error",
                        "human": "The comparator is not used on a SimpleQuantity",
                        "expression": "comparator.empty()",
                        "xpath": "not(exists(f:comparator))",
                        "source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN (see also Range) or CQ"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ, IVL<PQ>, MO, CO, depending on the values"
                    },
                    {
                        "identity": "rim",
                        "map": "not supported"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration.id",
                "path": "MedicationStatement.dosage.maxDosePerAdministration.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.maxDosePerAdministration.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration.value",
                "path": "MedicationStatement.dosage.maxDosePerAdministration.value",
                "short": "Numerical value (with implicit precision)",
                "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
                "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
                "requirements": "Precision is handled implicitly in almost all cases of measurement.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "decimal"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN.2  / CQ - N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration.comparator",
                "path": "MedicationStatement.dosage.maxDosePerAdministration.comparator",
                "short": "< | <= | >= | > - how to understand the value",
                "definition": "Not allowed to be used in this context",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Quantity.comparator",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "QuantityComparator"
                        }
                    ],
                    "strength": "required",
                    "description": "How the Quantity should be understood and represented.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN.1  / CQ.1"
                    },
                    {
                        "identity": "rim",
                        "map": "IVL properties"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration.unit",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "MedicationStatement.dosage.maxDosePerAdministration.unit",
                "short": "Unit representation",
                "definition": "A human-readable form of the unit.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.unit",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.unit"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration.system",
                "path": "MedicationStatement.dosage.maxDosePerAdministration.system",
                "short": "System that defines coded unit form",
                "definition": "The identification of the system that provides the coded form of the unit.",
                "comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier",
                "requirements": "Need to know the system that defines the coded form of the unit.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1",
                    "qty-3"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "CO.codeSystem, PQ.translation.codeSystem"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerAdministration.code",
                "path": "MedicationStatement.dosage.maxDosePerAdministration.code",
                "short": "Coded form of the unit",
                "definition": "A computer processable form of the unit in some unit representation system.",
                "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
                "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.code, MO.currency, PQ.translation.code"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.maxDosePerLifetime",
                "short": "Upper limit on medication per lifetime of the patient",
                "definition": "Upper limit on medication per lifetime of the patient.",
                "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
                "requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Dosage.maxDosePerLifetime",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "Quantity",
                        "profile":  [
                            "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                        ]
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "qty-3",
                        "severity": "error",
                        "human": "If a code for the unit is present, the system SHALL also be present",
                        "expression": "code.empty() or system.exists()",
                        "xpath": "not(exists(f:code)) or exists(f:system)",
                        "source": "http://hl7.org/fhir/StructureDefinition/Quantity"
                    },
                    {
                        "key": "sqty-1",
                        "severity": "error",
                        "human": "The comparator is not used on a SimpleQuantity",
                        "expression": "comparator.empty()",
                        "xpath": "not(exists(f:comparator))",
                        "source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
                    }
                ],
                "isModifier": false,
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN (see also Range) or CQ"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ, IVL<PQ>, MO, CO, depending on the values"
                    },
                    {
                        "identity": "rim",
                        "map": "not supported"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime.id",
                "path": "MedicationStatement.dosage.maxDosePerLifetime.id",
                "representation":  [
                    "xmlAttr"
                ],
                "short": "Unique id for inter-element referencing",
                "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Element.id",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "extension":  [
                            {
                                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                                "valueUrl": "string"
                            }
                        ],
                        "code": "http://hl7.org/fhirpath/System.String"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime.extension",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
                        "valueCode": "normative"
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
                        "valueCode": "4.0.0"
                    }
                ],
                "path": "MedicationStatement.dosage.maxDosePerLifetime.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "description": "Extensions are always sliced by (at least) url",
                    "rules": "open"
                },
                "short": "Additional content defined by implementations",
                "definition": "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": "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":  [
                    "extensions",
                    "user content"
                ],
                "min": 0,
                "max": "*",
                "base": {
                    "path": "Element.extension",
                    "min": 0,
                    "max": "*"
                },
                "type":  [
                    {
                        "code": "Extension"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    },
                    {
                        "key": "ext-1",
                        "severity": "error",
                        "human": "Must have either extensions or value[x], not both",
                        "expression": "extension.exists() != value.exists()",
                        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
                        "source": "http://hl7.org/fhir/StructureDefinition/Extension"
                    }
                ],
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "rim",
                        "map": "N/A"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime.value",
                "path": "MedicationStatement.dosage.maxDosePerLifetime.value",
                "short": "Numerical value (with implicit precision)",
                "definition": "The value of the measured amount. The value includes an implicit precision in the presentation of the value.",
                "comment": "The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).",
                "requirements": "Precision is handled implicitly in almost all cases of measurement.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.value",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "decimal"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN.2  / CQ - N/A"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime.comparator",
                "path": "MedicationStatement.dosage.maxDosePerLifetime.comparator",
                "short": "< | <= | >= | > - how to understand the value",
                "definition": "Not allowed to be used in this context",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.",
                "min": 0,
                "max": "0",
                "base": {
                    "path": "Quantity.comparator",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "meaningWhenMissing": "If there is no comparator, then there is no modification of the value",
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isModifier": true,
                "isModifierReason": "This is labeled as \"Is Modifier\" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value",
                "isSummary": true,
                "binding": {
                    "extension":  [
                        {
                            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
                            "valueString": "QuantityComparator"
                        }
                    ],
                    "strength": "required",
                    "description": "How the Quantity should be understood and represented.",
                    "valueSet": "http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1"
                },
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "SN.1  / CQ.1"
                    },
                    {
                        "identity": "rim",
                        "map": "IVL properties"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime.unit",
                "extension":  [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
                        "valueBoolean": true
                    }
                ],
                "path": "MedicationStatement.dosage.maxDosePerLifetime.unit",
                "short": "Unit representation",
                "definition": "A human-readable form of the unit.",
                "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
                "requirements": "There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.unit",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "string"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.unit"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime.system",
                "path": "MedicationStatement.dosage.maxDosePerLifetime.system",
                "short": "System that defines coded unit form",
                "definition": "The identification of the system that provides the coded form of the unit.",
                "comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier",
                "requirements": "Need to know the system that defines the coded form of the unit.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.system",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "uri"
                    }
                ],
                "condition":  [
                    "ele-1",
                    "qty-3"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "CO.codeSystem, PQ.translation.codeSystem"
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage.maxDosePerLifetime.code",
                "path": "MedicationStatement.dosage.maxDosePerLifetime.code",
                "short": "Coded form of the unit",
                "definition": "A computer processable form of the unit in some unit representation system.",
                "comment": "The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system.",
                "requirements": "Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.",
                "min": 0,
                "max": "1",
                "base": {
                    "path": "Quantity.code",
                    "min": 0,
                    "max": "1"
                },
                "type":  [
                    {
                        "code": "code"
                    }
                ],
                "condition":  [
                    "ele-1"
                ],
                "constraint":  [
                    {
                        "key": "ele-1",
                        "severity": "error",
                        "human": "All FHIR elements must have a @value or children",
                        "expression": "hasValue() or (children().count() > id.count())",
                        "xpath": "@value|f:*|h:div",
                        "source": "http://hl7.org/fhir/StructureDefinition/Element"
                    }
                ],
                "isSummary": true,
                "mapping":  [
                    {
                        "identity": "rim",
                        "map": "n/a"
                    },
                    {
                        "identity": "v2",
                        "map": "(see OBX.6 etc.) / CQ.2"
                    },
                    {
                        "identity": "rim",
                        "map": "PQ.code, MO.currency, PQ.translation.code"
                    }
                ]
            }
        ]
    },
    "differential": {
        "element":  [
            {
                "id": "MedicationStatement",
                "path": "MedicationStatement",
                "constraint":  [
                    {
                        "key": "ssr-pretreat-1",
                        "severity": "error",
                        "human": "If medication is \"Aflibercept\" then SHALL have a value for dosage.doseAndRate.doseQuantity.value",
                        "expression": "medicationCodeableConcept.coding.where(system='http://snomed.info.sct' and code = '703840003').count() = 0 or dosage.doseAndRate.doseQuantity.value.exists()"
                    }
                ]
            },
            {
                "id": "MedicationStatement.medication[x]",
                "path": "MedicationStatement.medication[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "binding": {
                    "strength": "required",
                    "valueSet": "https://frbresearch.org/fhir/ValueSet/ssr-pretreatments"
                }
            },
            {
                "id": "MedicationStatement.medication[x].coding",
                "path": "MedicationStatement.medication[x].coding",
                "min": 1
            },
            {
                "id": "MedicationStatement.medication[x].coding.system",
                "path": "MedicationStatement.medication[x].coding.system",
                "min": 1
            },
            {
                "id": "MedicationStatement.medication[x].coding.code",
                "path": "MedicationStatement.medication[x].coding.code",
                "min": 1
            },
            {
                "id": "MedicationStatement.subject",
                "path": "MedicationStatement.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://frbresearch.org/fhir/StructureDefinition/SSRPatient"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationStatement.context",
                "path": "MedicationStatement.context",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://frbresearch.org/fhir/StructureDefinition/SSREncounter"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationStatement.dosage",
                "path": "MedicationStatement.dosage",
                "min": 1
            },
            {
                "id": "MedicationStatement.dosage.site",
                "path": "MedicationStatement.dosage.site",
                "min": 1,
                "binding": {
                    "strength": "required",
                    "valueSet": "https://frbresearch.org/fhir/ValueSet/ssr-eye-body-site"
                }
            },
            {
                "id": "MedicationStatement.dosage.site.coding",
                "path": "MedicationStatement.dosage.site.coding",
                "min": 1
            },
            {
                "id": "MedicationStatement.dosage.site.coding.system",
                "path": "MedicationStatement.dosage.site.coding.system",
                "min": 1
            },
            {
                "id": "MedicationStatement.dosage.site.coding.code",
                "path": "MedicationStatement.dosage.site.coding.code",
                "min": 1
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x]",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x]",
                "min": 1,
                "type":  [
                    {
                        "code": "Quantity"
                    }
                ],
                "condition":  [
                    "ssr-pretreat-1"
                ]
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].value",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].value",
                "short": "2 | 8",
                "min": 1
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].unit",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].unit",
                "fixedString": "mg"
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].system",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].system",
                "fixedUri": "http://unitsofmeasure.org"
            },
            {
                "id": "MedicationStatement.dosage.doseAndRate.dose[x].code",
                "path": "MedicationStatement.dosage.doseAndRate.dose[x].code",
                "fixedCode": "mg"
            }
        ]
    }
}

<StructureDefinition xmlns="http://hl7.org/fhir">
    <url value="https://frbresearch.org/fhir/StructureDefinition/SSRPreTreatment" />
    <name value="SSRPreTreatment" />
    <title value="SSR Pre Treatment" />
    <status value="draft" />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationStatement" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
    <derivation value="constraint" />
    <snapshot>
        <element id="MedicationStatement">
            <path value="MedicationStatement" />
            <short value="Record of medication being taken by a patient" />
            <definition value="A record of a medication that is being consumed by a patient.   A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future.  The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician.  A common scenario where this information is captured is during the history taking process during a patient visit or stay.   The medication information may come from sources such as the patient&#39;s memory, from a prescription bottle,  or from a list of medications the patient, clinician or other party maintains. \n\nThe primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication.  A medication statement is often, if not always, less specific.  There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise.  As stated earlier, the medication statement information may come from the patient&#39;s memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains.  Medication administration is more formal and is not missing detailed information." />
            <comment value="When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:\nMedicationStatement.status + MedicationStatement.wasNotTaken\nStatus=Active + NotTaken=T = Not currently taking\nStatus=Completed + NotTaken=T = Not taken in the past\nStatus=Intended + NotTaken=T = No intention of taking\nStatus=Active + NotTaken=F = Taking, but not as prescribed\nStatus=Active + NotTaken=F = Taking\nStatus=Intended +NotTaken= F = Will be taking (not started)\nStatus=Completed + NotTaken=F = Taken in past\nStatus=In Error + NotTaken=N/A = In Error." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement" />
                <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-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-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(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()" />
                <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))" />
                <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="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>
                <key value="ssr-pretreat-1" />
                <severity value="error" />
                <human value="If medication is &quot;Aflibercept&quot; then SHALL have a value for dosage.doseAndRate.doseQuantity.value" />
                <expression value="medicationCodeableConcept.coding.where(system=&#39;http://snomed.info.sct&#39; and code = &#39;703840003&#39;).count() = 0 or dosage.doseAndRate.doseQuantity.value.exists()" />
                <source value="https://frbresearch.org/fhir/StructureDefinition/SSRPreTreatment" />
            </constraint>
            <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="SubstanceAdministration" />
            </mapping>
        </element>
        <element id="MedicationStatement.id">
            <path value="MedicationStatement.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="string" />
                </extension>
                <code value="http://hl7.org/fhirpath/System.String" />
            </type>
            <isSummary value="true" />
        </element>
        <element id="MedicationStatement.meta">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.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>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.implicitRules">
            <path value="MedicationStatement.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&#39;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>
            <condition value="ele-1" />
            <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&#39;s meaning or interpretation" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.language">
            <path value="MedicationStatement.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>
            <condition value="ele-1" />
            <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>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
                    <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="Language" />
                </extension>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
                    <valueBoolean value="true" />
                </extension>
                <strength value="preferred" />
                <description value="A human language." />
                <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.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>
            <condition value="ele-1" />
            <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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act.text?" />
            </mapping>
        </element>
        <element id="MedicationStatement.contained">
            <path value="MedicationStatement.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>
            <mapping>
                <identity value="rim" />
                <map value="Entity. Role, or Act" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.modifierExtension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.modifierExtension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
            <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <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" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.identifier">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.identifier" />
            <short value="External identifier" />
            <definition value="Identifiers associated with this Medication Statement 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="MedicationStatement.identifier" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Identifier" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
            </mapping>
            <mapping>
                <identity value="servd" />
                <map value="Identifier" />
            </mapping>
            <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>
        </element>
        <element id="MedicationStatement.basedOn">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.basedOn" />
            <short value="Fulfils plan, proposal or order" />
            <definition value="A plan, proposal or order that is fulfilled in whole or in part by this event." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <requirements value="Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.basedOn" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
            </type>
            <condition value="ele-1" />
            <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="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.basedOn" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]" />
            </mapping>
        </element>
        <element id="MedicationStatement.partOf">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.partOf" />
            <short value="Part of referenced event" />
            <definition value="A larger event of which this particular event is a component or step." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <requirements value="This should not be used when indicating which resource a MedicationStatement has been derived from.  If that is the use case, then MedicationStatement.derivedFrom should be used." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.partOf" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
            </type>
            <condition value="ele-1" />
            <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="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.partOf" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]" />
            </mapping>
        </element>
        <element id="MedicationStatement.status">
            <path value="MedicationStatement.status" />
            <short value="active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken" />
            <definition value="A code representing the patient or other source&#39;s judgment about the state of the medication used that this statement is about.  Generally, this will be active or completed." />
            <comment value="MedicationStatement is a statement at a point in time.  The status is only representative at the point when it was asserted.  The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error).\n\nThis 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="MedicationStatement.status" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <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="MedicationStatementStatus" />
                </extension>
                <strength value="required" />
                <description value="A coded concept indicating the current status of a MedicationStatement." />
                <valueSet value="http://hl7.org/fhir/ValueSet/medication-statement-status|4.0.1" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <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>
        </element>
        <element id="MedicationStatement.statusReason">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.statusReason" />
            <short value="Reason for current status" />
            <definition value="Captures the reason for the current state of the MedicationStatement." />
            <comment value="This is generally only used for &quot;exception&quot; statuses such as &quot;not-taken&quot;, &quot;on-hold&quot;, &quot;cancelled&quot; or &quot;entered-in-error&quot;. The reason for performing the event at all is captured in reasonCode, not here." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.statusReason" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationStatementStatusReason" />
                </extension>
                <strength value="example" />
                <description value="A coded concept indicating the reason for the status of the statement." />
                <valueSet value="http://hl7.org/fhir/ValueSet/reason-medication-status-codes" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.statusReason" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde" />
            </mapping>
        </element>
        <element id="MedicationStatement.category">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.category" />
            <short value="Type of medication usage" />
            <definition value="Indicates where the medication is expected to be consumed or administered." />
            <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.category" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationStatementCategory" />
                </extension>
                <strength value="preferred" />
                <description value="A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/medication-statement-category" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.class" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;type of medication usage&quot;].value" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.medication[x]" />
            <short value="What medication was taken" />
            <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="MedicationStatement.medication[x]" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationCode" />
                </extension>
                <strength value="required" />
                <description value="A coded concept identifying the substance or product being taken." />
                <valueSet value="https://frbresearch.org/fhir/ValueSet/ssr-pretreatments" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.code" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.what[x]" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=CSM].role[classCode=ADMM or MANU]" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].id">
            <path value="MedicationStatement.medication[x].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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.medication[x].extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.medication[x].coding" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
            <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding.id">
            <path value="MedicationStatement.medication[x].coding.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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.medication[x].coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding.system">
            <path value="MedicationStatement.medication[x].coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding.version">
            <path value="MedicationStatement.medication[x].coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding.code">
            <path value="MedicationStatement.medication[x].coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="MedicationStatement.medication[x].coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].coding.userSelected">
            <path value="MedicationStatement.medication[x].coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="MedicationStatement.medication[x].text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="MedicationStatement.medication[x].text" />
            <short value="Plain text representation of the concept" />
            <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="MedicationStatement.subject">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.subject" />
            <short value="Who is/was taking  the medication" />
            <definition value="The person, animal or group who is/was taking the medication." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.subject" />
                <min value="1" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="https://frbresearch.org/fhir/StructureDefinition/SSRPatient" />
            </type>
            <condition value="ele-1" />
            <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="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <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="MedicationStatement.context">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.context" />
            <short value="Encounter / Episode associated with MedicationStatement" />
            <definition value="The encounter or episode of care that establishes the context for this MedicationStatement." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.context" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="https://frbresearch.org/fhir/StructureDefinition/SSREncounter" />
            </type>
            <condition value="ele-1" />
            <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="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <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="MedicationStatement.effective[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.effective[x]" />
            <short value="The date/time or interval when the medication is/was/will be taken" />
            <definition value="The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No)." />
            <comment value="This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the &quot;end&quot; date will be omitted.  The date/time attribute supports a variety of dates - year, year/month and exact date.  If something more than this is required, this should be conveyed as text." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.effective[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <type>
                <code value="Period" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.occurrence[x]" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.done[x]" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".effectiveTime" />
            </mapping>
        </element>
        <element id="MedicationStatement.dateAsserted">
            <path value="MedicationStatement.dateAsserted" />
            <short value="When the statement was asserted?" />
            <definition value="The date when the medication statement was asserted by the information source." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.dateAsserted" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="dateTime" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.recorded" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=AUT].time" />
            </mapping>
        </element>
        <element id="MedicationStatement.informationSource">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.informationSource" />
            <short value="Person or organization that provided the information about the taking of this medication" />
            <definition value="The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest." />
            <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="MedicationStatement.informationSource" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
            </type>
            <condition value="ele-1" />
            <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="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.source" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)" />
            </mapping>
        </element>
        <element id="MedicationStatement.derivedFrom">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.derivedFrom" />
            <short value="Additional supporting information" />
            <definition value="Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement." />
            <comment value="Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers.  The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim.  it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.derivedFrom" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
            </type>
            <condition value="ele-1" />
            <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="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]" />
            </mapping>
        </element>
        <element id="MedicationStatement.reasonCode">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.reasonCode" />
            <short value="Reason for why the medication is being/was taken" />
            <definition value="A reason for why the medication is being/was taken." />
            <comment value="This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.reasonCode" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationReason" />
                </extension>
                <strength value="example" />
                <description value="A coded concept identifying why the medication is being taken." />
                <valueSet value="http://hl7.org/fhir/ValueSet/condition-code" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.reasonCode" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.why[x]" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".reasonCode" />
            </mapping>
        </element>
        <element id="MedicationStatement.reasonReference">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.reasonReference" />
            <short value="Condition or observation that supports why the medication is being/was taken" />
            <definition value="Condition or observation that supports why the medication is being/was taken." />
            <comment value="This is a reference to a condition that is the reason why the medication is being/was taken.  If only a code exists, use reasonForUseCode." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.reasonReference" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
            </type>
            <condition value="ele-1" />
            <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="ref-1" />
                <severity value="error" />
                <human value="SHALL have a contained resource if a local reference is provided" />
                <expression value="reference.startsWith(&#39;#&#39;).not() or (reference.substring(1).trace(&#39;url&#39;) in %rootResource.contained.id.trace(&#39;ids&#39;))" />
                <xpath value="not(starts-with(f:reference/@value, &#39;#&#39;)) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, &#39;#&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.reasonReference" />
            </mapping>
            <mapping>
                <identity value="w5" />
                <map value="FiveWs.why[x]" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=&quot;reason for use&quot;].value" />
            </mapping>
        </element>
        <element id="MedicationStatement.note">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.note" />
            <short value="Further information about the statement" />
            <definition value="Provides extra information about the medication statement that is not conveyed by the other attributes." />
            <comment value="For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate &quot;modifying&quot; information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.note" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Annotation" />
            </type>
            <condition value="ele-1" />
            <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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="Act" />
            </mapping>
            <mapping>
                <identity value="workflow" />
                <map value="Event.note" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code=&quot;annotation&quot;].value" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="trial-use" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage" />
            <short value="Details of how medication is/was taken or should be taken" />
            <definition value="Indicates how the medication is/was or should be taken by the patient." />
            <comment value="The dates included in the dosage on a Medication Statement reflect the dates for a given dose.  For example, &quot;from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily.&quot;  It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest." />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="MedicationStatement.dosage" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Dosage" />
            </type>
            <condition value="ele-1" />
            <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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="refer dosageInstruction mapping" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.id">
            <path value="MedicationStatement.dosage.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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.modifierExtension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.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&#39;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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
            <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
            <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <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>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.sequence">
            <path value="MedicationStatement.dosage.sequence" />
            <short value="The order of the dosage instructions" />
            <definition value="Indicates the order in which the dosage instructions should be applied or interpreted." />
            <comment value="32 bit number; for values larger than this, use decimal" />
            <requirements value="If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent.  If the sequence number is different, then the Dosages are intended to be sequential." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.sequence" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="integer" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="TQ1-1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".text" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.text">
            <path value="MedicationStatement.dosage.text" />
            <short value="Free text dosage instructions e.g. SIG" />
            <definition value="Free text dosage instructions e.g. SIG." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Free text dosage instructions can be used for cases where the instructions are too complex to code.  The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated.  If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing.  Additional information about administration or preparation of the medication should be included as text." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXO-6; RXE-21" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".text" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.additionalInstruction">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.additionalInstruction" />
            <short value="Supplemental instruction or warnings to the patient - e.g. &quot;with meals&quot;, &quot;may cause drowsiness&quot;" />
            <definition value="Supplemental instructions to the patient on how to take the medication  (e.g. &quot;with meals&quot; or&quot;take half to one hour before food&quot;) or warnings for the patient about the medication (e.g. &quot;may cause drowsiness&quot; or &quot;avoid exposure of skin to direct sunlight or sunlamps&quot;)." />
            <comment value="Information about administration or preparation of the medication (e.g. &quot;infuse as rapidly as possibly via intraperitoneal port&quot; or &quot;immediately following drug x&quot;) should be populated in dosage.text." />
            <requirements value="Additional instruction is intended to be coded, but where no code exists, the element could include text.  For example, &quot;Swallow with plenty of water&quot; which might or might not be coded." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Dosage.additionalInstruction" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="AdditionalInstruction" />
                </extension>
                <strength value="example" />
                <description value="A coded concept identifying additional instructions such as &quot;take with water&quot; or &quot;avoid operating heavy machinery&quot;." />
                <valueSet value="http://hl7.org/fhir/ValueSet/additional-instruction-codes" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXO-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".text" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.patientInstruction">
            <path value="MedicationStatement.dosage.patientInstruction" />
            <short value="Patient or consumer oriented instructions" />
            <definition value="Instructions in terms that are understood by the patient or consumer." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.patientInstruction" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXO-7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".text" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.timing">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.timing" />
            <short value="When medication should be administered" />
            <definition value="When medication should be administered." />
            <comment value="This attribute might not always be populated while the Dosage.text is expected to be populated.  If both are populated, then the Dosage.text should reflect the content of the Dosage.timing." />
            <requirements value="The timing schedule for giving the medication to the patient. This  data type allows many different expressions. For example: &quot;Every 8 hours&quot;; &quot;Three times a day&quot;; &quot;1/2 an hour before breakfast for 10 days from 23-Dec 2011:&quot;; &quot;15 Oct 2013, 17 Oct 2013 and 1 Nov 2013&quot;.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn&#39;t imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.timing" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Timing" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="QSET&lt;TS&gt; (GTS)" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".effectiveTime" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.asNeeded[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.asNeeded[x]" />
            <short value="Take &quot;as needed&quot; (for x)" />
            <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept)." />
            <comment value="Can express &quot;as needed&quot; without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express &quot;as needed&quot; with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not &quot;prn&quot; or &quot;as needed&quot;." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.asNeeded[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationAsNeededReason" />
                </extension>
                <strength value="example" />
                <description value="A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose.  For example &quot;pain&quot;, &quot;30 minutes prior to sexual intercourse&quot;, &quot;on flare-up&quot; etc." />
                <valueSet value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="TQ1-9" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=&quot;as needed&quot;].value=boolean or codable concept" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.site" />
            <short value="Body site to administer to" />
            <definition value="Body site to administer to." />
            <comment value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both." />
            <requirements value="A coded specification of the anatomic site where the medication first enters the body." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Dosage.site" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationAdministrationSite" />
                </extension>
                <strength value="required" />
                <description value="A coded concept describing the site location the medicine enters into or onto the body." />
                <valueSet value="https://frbresearch.org/fhir/ValueSet/ssr-eye-body-site" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXR-2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".approachSiteCode" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.id">
            <path value="MedicationStatement.dosage.site.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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.site.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.site.coding" />
            <short value="Code defined by a terminology system" />
            <definition value="A reference to a code defined by a terminology system." />
            <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
            <requirements value="Allows for alternative encodings within a code system, and translations to other code systems." />
            <min value="1" />
            <max value="*" />
            <base>
                <path value="CodeableConcept.coding" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Coding" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1-8, C*E.10-22" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="union(., ./translation)" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding.id">
            <path value="MedicationStatement.dosage.site.coding.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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.site.coding.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding.system">
            <path value="MedicationStatement.dosage.site.coding.system" />
            <short value="Identity of the terminology system" />
            <definition value="The identification of the code system that defines the meaning of the symbol in the code." />
            <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously." />
            <requirements value="Need to be unambiguous about the source of the definition of the symbol." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystem" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding.version">
            <path value="MedicationStatement.dosage.site.coding.version" />
            <short value="Version of the system - if relevant" />
            <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged." />
            <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.version" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.7" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./codeSystemVersion" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding.code">
            <path value="MedicationStatement.dosage.site.coding.code" />
            <short value="Symbol in syntax defined by the system" />
            <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Need to refer to a particular code in the system." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Coding.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./code" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding.display">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="MedicationStatement.dosage.site.coding.display" />
            <short value="Representation defined by the system" />
            <definition value="A representation of the meaning of the code in the system, following the rules of the system." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.display" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.2 - but note this is not well followed" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CV.displayName" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.coding.userSelected">
            <path value="MedicationStatement.dosage.site.coding.userSelected" />
            <short value="If this coding was chosen directly by the user" />
            <definition value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)." />
            <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely." />
            <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Coding.userSelected" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="boolean" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="Sometimes implied by being first" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD.codingRationale" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.site.text">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="MedicationStatement.dosage.site.text" />
            <short value="Plain text representation of the concept" />
            <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user." />
            <comment value="Very often the text is the same as a displayName of one of the codings." />
            <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="CodeableConcept.text" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="C*E.9. But note many systems use C*E.2 for this" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.route">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.route" />
            <short value="How drug should enter body" />
            <definition value="How drug should enter body." />
            <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
            <requirements value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient&#39;s body." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.route" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="RouteOfAdministration" />
                </extension>
                <strength value="example" />
                <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject." />
                <valueSet value="http://hl7.org/fhir/ValueSet/route-codes" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXR-1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".routeCode" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.method">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.method" />
            <short value="Technique for administering medication" />
            <definition value="Technique for administering medication." />
            <comment value="Terminologies used often pre-coordinate this term with the route and or form of administration." />
            <requirements value="A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections.  For examples, Slow Push; Deep IV." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.method" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="MedicationAdministrationMethod" />
                </extension>
                <strength value="example" />
                <description value="A coded concept describing the technique by which the medicine is administered." />
                <valueSet value="http://hl7.org/fhir/ValueSet/administration-method-codes" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXR-4" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".doseQuantity" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.doseAndRate" />
            <short value="Amount of medication administered" />
            <definition value="The amount of medication administered." />
            <min value="0" />
            <max value="*" />
            <base>
                <path value="Dosage.doseAndRate" />
                <min value="0" />
                <max value="*" />
            </base>
            <type>
                <code value="Element" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="TQ1-2" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.id">
            <path value="MedicationStatement.dosage.doseAndRate.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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.doseAndRate.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.type">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.doseAndRate.type" />
            <short value="The kind of dose or rate specified" />
            <definition value="The kind of dose or rate specified, for example, ordered or calculated." />
            <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
            <requirements value="If the type is not populated, assume to be &quot;ordered&quot;." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.doseAndRate.type" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="CodeableConcept" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="DoseAndRateType" />
                </extension>
                <strength value="example" />
                <description value="The kind of dose or rate specified." />
                <valueSet value="http://hl7.org/fhir/ValueSet/dose-rate-type" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="CE/CNE/CWE" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CD" />
            </mapping>
            <mapping>
                <identity value="orim" />
                <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXO-21; RXE-23" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.doseAndRate.dose[x]" />
            <short value="Amount of medication per dose" />
            <definition value="Amount of medication per dose." />
            <comment value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours." />
            <requirements value="The amount of therapeutic or other substance given at one administration event." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Dosage.doseAndRate.dose[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <condition value="ele-1" />
            <condition value="ssr-pretreat-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXO-2, RXE-3" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".doseQuantity" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].id">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].value">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].value" />
            <short value="2 | 8" />
            <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
            <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
            <requirements value="Precision is handled implicitly in almost all cases of measurement." />
            <min value="1" />
            <max value="1" />
            <base>
                <path value="Quantity.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="decimal" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN.2  / CQ - N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].comparator">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].comparator" />
            <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value" />
            <definition value="Not allowed to be used in this context" />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L due to the limitations of measuring methodology." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Quantity.comparator" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
            <condition value="ele-1" />
            <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 is labeled as &quot;Is Modifier&quot; because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="QuantityComparator" />
                </extension>
                <strength value="required" />
                <description value="How the Quantity should be understood and represented." />
                <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN.1  / CQ.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="IVL properties" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].unit">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].unit" />
            <short value="Unit representation" />
            <definition value="A human-readable form of the unit." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.unit" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <fixedString value="mg" />
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.unit" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].system">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].system" />
            <short value="System that defines coded unit form" />
            <definition value="The identification of the system that provides the coded form of the unit." />
            <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
            <requirements value="Need to know the system that defines the coded form of the unit." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <fixedUri value="http://unitsofmeasure.org" />
            <condition value="ele-1" />
            <condition value="qty-3" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CO.codeSystem, PQ.translation.codeSystem" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].code">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].code" />
            <short value="Coded form of the unit" />
            <definition value="A computer processable form of the unit in some unit representation system." />
            <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system." />
            <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <fixedCode value="mg" />
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.code, MO.currency, PQ.translation.code" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.rate[x]">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.doseAndRate.rate[x]" />
            <short value="Amount of medication per unit of time" />
            <definition value="Amount of medication per unit of time." />
            <comment value="It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.\n\nIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity.  The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator.  Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour." />
            <requirements value="Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr.  May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours.   Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.  Sometimes, a rate can imply duration when expressed as total volume / duration (e.g.  500mL/2 hours implies a duration of 2 hours).  However, when rate doesn&#39;t imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.doseAndRate.rate[x]" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Ratio" />
            </type>
            <type>
                <code value="Range" />
            </type>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXE22, RXE23, RXE-24" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".rateQuantity" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerPeriod">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.maxDosePerPeriod" />
            <short value="Upper limit on medication per unit of time" />
            <definition value="Upper limit on medication per unit of time." />
            <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example &quot;2 tablets every 4 hours to a maximum of 8/day&quot;." />
            <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time.  For example, 1000mg in 24 hours." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.maxDosePerPeriod" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Ratio" />
            </type>
            <condition value="ele-1" />
            <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="rat-1" />
                <severity value="error" />
                <human value="Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present" />
                <expression value="(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())" />
                <xpath value="(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) &gt; 0) or (count(f:extension) &gt; 0))" />
                <source value="http://hl7.org/fhir/StructureDefinition/Ratio" />
            </constraint>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="RTO" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="RXO-23, RXE-19" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value=".maxDoseQuantity" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.maxDosePerAdministration" />
            <short value="Upper limit on medication per administration" />
            <definition value="Upper limit on medication per administration." />
            <comment value="This is intended for use as an adjunct to the dosage when there is an upper cap.  For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg." />
            <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.maxDosePerAdministration" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <condition value="ele-1" />
            <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="qty-3" />
                <severity value="error" />
                <human value="If a code for the unit is present, the system SHALL also be present" />
                <expression value="code.empty() or system.exists()" />
                <xpath value="not(exists(f:code)) or exists(f:system)" />
                <source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
            </constraint>
            <constraint>
                <key value="sqty-1" />
                <severity value="error" />
                <human value="The comparator is not used on a SimpleQuantity" />
                <expression value="comparator.empty()" />
                <xpath value="not(exists(f:comparator))" />
                <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN (see also Range) or CQ" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="not supported" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration.id">
            <path value="MedicationStatement.dosage.maxDosePerAdministration.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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.maxDosePerAdministration.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration.value">
            <path value="MedicationStatement.dosage.maxDosePerAdministration.value" />
            <short value="Numerical value (with implicit precision)" />
            <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
            <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
            <requirements value="Precision is handled implicitly in almost all cases of measurement." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="decimal" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN.2  / CQ - N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration.comparator">
            <path value="MedicationStatement.dosage.maxDosePerAdministration.comparator" />
            <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value" />
            <definition value="Not allowed to be used in this context" />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L due to the limitations of measuring methodology." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Quantity.comparator" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
            <condition value="ele-1" />
            <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 is labeled as &quot;Is Modifier&quot; because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="QuantityComparator" />
                </extension>
                <strength value="required" />
                <description value="How the Quantity should be understood and represented." />
                <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN.1  / CQ.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="IVL properties" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration.unit">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="MedicationStatement.dosage.maxDosePerAdministration.unit" />
            <short value="Unit representation" />
            <definition value="A human-readable form of the unit." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.unit" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.unit" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration.system">
            <path value="MedicationStatement.dosage.maxDosePerAdministration.system" />
            <short value="System that defines coded unit form" />
            <definition value="The identification of the system that provides the coded form of the unit." />
            <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
            <requirements value="Need to know the system that defines the coded form of the unit." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <condition value="qty-3" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CO.codeSystem, PQ.translation.codeSystem" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerAdministration.code">
            <path value="MedicationStatement.dosage.maxDosePerAdministration.code" />
            <short value="Coded form of the unit" />
            <definition value="A computer processable form of the unit in some unit representation system." />
            <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system." />
            <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.code, MO.currency, PQ.translation.code" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.maxDosePerLifetime" />
            <short value="Upper limit on medication per lifetime of the patient" />
            <definition value="Upper limit on medication per lifetime of the patient." />
            <comment value="The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
            <requirements value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Dosage.maxDosePerLifetime" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="Quantity" />
                <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </type>
            <condition value="ele-1" />
            <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="qty-3" />
                <severity value="error" />
                <human value="If a code for the unit is present, the system SHALL also be present" />
                <expression value="code.empty() or system.exists()" />
                <xpath value="not(exists(f:code)) or exists(f:system)" />
                <source value="http://hl7.org/fhir/StructureDefinition/Quantity" />
            </constraint>
            <constraint>
                <key value="sqty-1" />
                <severity value="error" />
                <human value="The comparator is not used on a SimpleQuantity" />
                <expression value="comparator.empty()" />
                <xpath value="not(exists(f:comparator))" />
                <source value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity" />
            </constraint>
            <isModifier value="false" />
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN (see also Range) or CQ" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="not supported" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime.id">
            <path value="MedicationStatement.dosage.maxDosePerLifetime.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>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime.extension">
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
                <valueCode value="normative" />
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
                <valueCode value="4.0.0" />
            </extension>
            <path value="MedicationStatement.dosage.maxDosePerLifetime.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <description value="Extensions are always sliced by (at least) url" />
                <rules value="open" />
            </slicing>
            <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>
            <condition value="ele-1" />
            <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(.), &#39;value&#39;)])" />
                <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
            </constraint>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="N/A" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime.value">
            <path value="MedicationStatement.dosage.maxDosePerLifetime.value" />
            <short value="Numerical value (with implicit precision)" />
            <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value." />
            <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)." />
            <requirements value="Precision is handled implicitly in almost all cases of measurement." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.value" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="decimal" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN.2  / CQ - N/A" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime.comparator">
            <path value="MedicationStatement.dosage.maxDosePerLifetime.comparator" />
            <short value="&lt; | &lt;= | &gt;= | &gt; - how to understand the value" />
            <definition value="Not allowed to be used in this context" />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="Need a framework for handling measures where the value is &lt;5ug/L or &gt;400mg/L due to the limitations of measuring methodology." />
            <min value="0" />
            <max value="0" />
            <base>
                <path value="Quantity.comparator" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <meaningWhenMissing value="If there is no comparator, then there is no modification of the value" />
            <condition value="ele-1" />
            <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 is labeled as &quot;Is Modifier&quot; because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value" />
            <isSummary value="true" />
            <binding>
                <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
                    <valueString value="QuantityComparator" />
                </extension>
                <strength value="required" />
                <description value="How the Quantity should be understood and represented." />
                <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1" />
            </binding>
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="SN.1  / CQ.1" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="IVL properties" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime.unit">
            <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
                <valueBoolean value="true" />
            </extension>
            <path value="MedicationStatement.dosage.maxDosePerLifetime.unit" />
            <short value="Unit representation" />
            <definition value="A human-readable form of the unit." />
            <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
            <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.unit" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="string" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.unit" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime.system">
            <path value="MedicationStatement.dosage.maxDosePerLifetime.system" />
            <short value="System that defines coded unit form" />
            <definition value="The identification of the system that provides the coded form of the unit." />
            <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
            <requirements value="Need to know the system that defines the coded form of the unit." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.system" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="uri" />
            </type>
            <condition value="ele-1" />
            <condition value="qty-3" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="CO.codeSystem, PQ.translation.codeSystem" />
            </mapping>
        </element>
        <element id="MedicationStatement.dosage.maxDosePerLifetime.code">
            <path value="MedicationStatement.dosage.maxDosePerLifetime.code" />
            <short value="Coded form of the unit" />
            <definition value="A computer processable form of the unit in some unit representation system." />
            <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency.  The context of use may additionally require a code from a particular system." />
            <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest." />
            <min value="0" />
            <max value="1" />
            <base>
                <path value="Quantity.code" />
                <min value="0" />
                <max value="1" />
            </base>
            <type>
                <code value="code" />
            </type>
            <condition value="ele-1" />
            <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>
            <isSummary value="true" />
            <mapping>
                <identity value="rim" />
                <map value="n/a" />
            </mapping>
            <mapping>
                <identity value="v2" />
                <map value="(see OBX.6 etc.) / CQ.2" />
            </mapping>
            <mapping>
                <identity value="rim" />
                <map value="PQ.code, MO.currency, PQ.translation.code" />
            </mapping>
        </element>
    </snapshot>
    <differential>
        <element id="MedicationStatement">
            <path value="MedicationStatement" />
            <constraint>
                <key value="ssr-pretreat-1" />
                <severity value="error" />
                <human value="If medication is &quot;Aflibercept&quot; then SHALL have a value for dosage.doseAndRate.doseQuantity.value" />
                <expression value="medicationCodeableConcept.coding.where(system=&#39;http://snomed.info.sct&#39; and code = &#39;703840003&#39;).count() = 0 or dosage.doseAndRate.doseQuantity.value.exists()" />
            </constraint>
        </element>
        <element id="MedicationStatement.medication[x]">
            <path value="MedicationStatement.medication[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <binding>
                <strength value="required" />
                <valueSet value="https://frbresearch.org/fhir/ValueSet/ssr-pretreatments" />
            </binding>
        </element>
        <element id="MedicationStatement.medication[x].coding">
            <path value="MedicationStatement.medication[x].coding" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.medication[x].coding.system">
            <path value="MedicationStatement.medication[x].coding.system" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.medication[x].coding.code">
            <path value="MedicationStatement.medication[x].coding.code" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.subject">
            <path value="MedicationStatement.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://frbresearch.org/fhir/StructureDefinition/SSRPatient" />
            </type>
        </element>
        <element id="MedicationStatement.context">
            <path value="MedicationStatement.context" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://frbresearch.org/fhir/StructureDefinition/SSREncounter" />
            </type>
        </element>
        <element id="MedicationStatement.dosage">
            <path value="MedicationStatement.dosage" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.dosage.site">
            <path value="MedicationStatement.dosage.site" />
            <min value="1" />
            <binding>
                <strength value="required" />
                <valueSet value="https://frbresearch.org/fhir/ValueSet/ssr-eye-body-site" />
            </binding>
        </element>
        <element id="MedicationStatement.dosage.site.coding">
            <path value="MedicationStatement.dosage.site.coding" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.dosage.site.coding.system">
            <path value="MedicationStatement.dosage.site.coding.system" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.dosage.site.coding.code">
            <path value="MedicationStatement.dosage.site.coding.code" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x]">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x]" />
            <min value="1" />
            <type>
                <code value="Quantity" />
            </type>
            <condition value="ssr-pretreat-1" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].value">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].value" />
            <short value="2 | 8" />
            <min value="1" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].unit">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].unit" />
            <fixedString value="mg" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].system">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].system" />
            <fixedUri value="http://unitsofmeasure.org" />
        </element>
        <element id="MedicationStatement.dosage.doseAndRate.dose[x].code">
            <path value="MedicationStatement.dosage.doseAndRate.dose[x].code" />
            <fixedCode value="mg" />
        </element>
    </differential>
</StructureDefinition>

MedicationStatement
Definition	A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.
Cardinality	0...*
Comments	When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered: MedicationStatement.status + MedicationStatement.wasNotTaken Status=Active + NotTaken=T = Not currently taking Status=Completed + NotTaken=T = Not taken in the past Status=Intended + NotTaken=T = No intention of taking Status=Active + NotTaken=F = Taking, but not as prescribed Status=Active + NotTaken=F = Taking Status=Intended +NotTaken= F = Will be taking (not started) Status=Completed + NotTaken=F = Taken in past Status=In Error + NotTaken=N/A = In Error.
Invariants	dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() ssr-pretreat-1: If medication is "Aflibercept" then SHALL have a value for dosage.doseAndRate.doseQuantity.value `medicationCodeableConcept.coding.where(system='http://snomed.info.sct' and code = '703840003').count() = 0 or dosage.doseAndRate.doseQuantity.value.exists()`
Mappings	rim: Entity. Role, or Act workflow: Event rim: SubstanceAdministration
MedicationStatement.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality	0...1
Type	string
Summary	True
Comments	The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
MedicationStatement.meta
Definition	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.
Cardinality	0...1
Type	Meta
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationStatement.implicitRules
Definition	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.
Cardinality	0...1
Type	uri
Modifier	True
Summary	True
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationStatement.language
Definition	The base language in which the resource is written.
Cardinality	0...1
Type	code
Binding	A human language. CommonLanguages (preferred)
Comments	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).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
MedicationStatement.text
Definition	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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality	0...1
Type	Narrative
Alias	narrative, html, xhtml, display
Comments	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 "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: Act.text?
MedicationStatement.contained
Definition	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.
Cardinality	0...*
Type	Resource
Alias	inline resources, anonymous resources, contained resources
Comments	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.
Mappings	rim: N/A
MedicationStatement.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
MedicationStatement.modifierExtension
Definition	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).
Cardinality	0...*
Type	Extension
Modifier	True
Alias	extensions, user content
Requirements	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.
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
MedicationStatement.identifier
Definition	Identifiers associated with this Medication Statement 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.
Cardinality	0...*
Type	Identifier
Summary	True
Comments	This is a business identifier, not a resource identifier.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.identifier w5: FiveWs.identifier rim: .id
MedicationStatement.basedOn
Definition	A plan, proposal or order that is fulfilled in whole or in part by this event.
Cardinality	0...*
Type	Reference(MedicationRequest \| CarePlan \| ServiceRequest)
Summary	True
Requirements	Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.basedOn rim: .outboundRelationship[typeCode=FLFS].target[classCode=SBADM or PROC or PCPR or OBS, moodCode=RQO orPLAN or PRP]
MedicationStatement.partOf
Definition	A larger event of which this particular event is a component or step.
Cardinality	0...*
Type	Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation)
Summary	True
Requirements	This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.partOf rim: .outboundRelationship[typeCode=COMP]/target[classCode=SPLY or SBADM or PROC or OBS,moodCode=EVN]
MedicationStatement.status
Definition	A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed.
Cardinality	1...1
Type	code
Binding	A coded concept indicating the current status of a MedicationStatement. Medication Status Codes (required)
Modifier	True
Summary	True
Comments	MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error). This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.status w5: FiveWs.status rim: .statusCode
MedicationStatement.statusReason
Definition	Captures the reason for the current state of the MedicationStatement.
Cardinality	0...*
Type	CodeableConcept
Binding	A coded concept indicating the reason for the status of the statement. SNOMEDCTDrugTherapyStatusCodes (example)
Comments	This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
MedicationStatement.category
Definition	Indicates where the medication is expected to be consumed or administered.
Cardinality	0...1
Type	CodeableConcept
Binding	A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered. Medication usage category codes (preferred)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.class rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication usage"].value
MedicationStatement.medication[x]
Definition	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.
Cardinality	1...1
Type	CodeableConcept
Binding	A coded concept identifying the substance or product being taken. ssr-pretreatments (required)
Summary	True
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.code w5: FiveWs.what[x] rim: .participation[typeCode=CSM].role[classCode=ADMM or MANU]
MedicationStatement.medication[x].id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationStatement.medication[x].extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationStatement.medication[x].coding
Definition	A reference to a code defined by a terminology system.
Cardinality	1...*
Type	Coding
Summary	True
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationStatement.medication[x].coding.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationStatement.medication[x].coding.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationStatement.medication[x].coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Cardinality	1...1
Type	uri
Summary	True
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Comments	The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationStatement.medication[x].coding.version
Definition	The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality	0...1
Type	string
Summary	True
Comments	Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationStatement.medication[x].coding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality	1...1
Type	code
Summary	True
Requirements	Need to refer to a particular code in the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationStatement.medication[x].coding.display
Definition	A representation of the meaning of the code in the system, following the rules of the system.
Cardinality	0...1
Type	string
Summary	True
Requirements	Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationStatement.medication[x].coding.userSelected
Definition	Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality	0...1
Type	boolean
Summary	True
Requirements	This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments	Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationStatement.medication[x].text
Definition	A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality	0...1
Type	string
Summary	True
Requirements	The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments	Very often the text is the same as a displayName of one of the codings.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
MedicationStatement.subject
Definition	The person, animal or group who is/was taking the medication.
Cardinality	1...1
Type	Reference(SSRPatient)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: FiveWs.subject
MedicationStatement.context
Definition	The encounter or episode of care that establishes the context for this MedicationStatement.
Cardinality	0...1
Type	Reference(SSREncounter)
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
MedicationStatement.effective[x]
Definition	The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No).
Cardinality	0...1
Type	dateTime
Summary	True
Comments	This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.occurrence[x] w5: FiveWs.done[x] rim: .effectiveTime
MedicationStatement.dateAsserted
Definition	The date when the medication statement was asserted by the information source.
Cardinality	0...1
Type	dateTime
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
MedicationStatement.informationSource
Definition	The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest.
Cardinality	0...1
Type	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	w5: FiveWs.source rim: .participation[typeCode=INF].role[classCode=PAT, or codes for Practioner or Related Person (if PAT is the informer, then syntax for self-reported =true)
MedicationStatement.derivedFrom
Definition	Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement.
Cardinality	0...*
Type	Reference(Resource)
Comments	Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .outboundRelationship[typeCode=SPRT]/target[classCode=ACT,moodCode=EVN]
MedicationStatement.reasonCode
Definition	A reason for why the medication is being/was taken.
Cardinality	0...*
Type	CodeableConcept
Binding	A coded concept identifying why the medication is being taken. Condition/Problem/DiagnosisCodes (example)
Comments	This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reasonCode w5: FiveWs.why[x] rim: .reasonCode
MedicationStatement.reasonReference
Definition	Condition or observation that supports why the medication is being/was taken.
Cardinality	0...*
Type	Reference(Condition \| Observation \| DiagnosticReport)
Comments	This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.reasonReference w5: FiveWs.why[x] rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="reason for use"].value
MedicationStatement.note
Definition	Provides extra information about the medication statement that is not conveyed by the other attributes.
Cardinality	0...*
Type	Annotation
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	workflow: Event.note rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=OBS,moodCode=EVN,code="annotation"].value
MedicationStatement.dosage
Definition	Indicates how the medication is/was or should be taken by the patient.
Cardinality	1...*
Type	Dosage
Comments	The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: refer dosageInstruction mapping
MedicationStatement.dosage.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationStatement.dosage.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationStatement.dosage.modifierExtension
Definition	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).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	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.
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: N/A
MedicationStatement.dosage.sequence
Definition	Indicates the order in which the dosage instructions should be applied or interpreted.
Cardinality	0...1
Type	integer
Summary	True
Requirements	If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: TQ1-1 rim: .text
MedicationStatement.dosage.text
Definition	Free text dosage instructions e.g. SIG.
Cardinality	0...1
Type	string
Summary	True
Requirements	Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXO-6; RXE-21 rim: .text
MedicationStatement.dosage.additionalInstruction
Definition	Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").
Cardinality	0...*
Type	CodeableConcept
Binding	A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example)
Summary	True
Requirements	Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.
Comments	Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXO-7 rim: .text
MedicationStatement.dosage.patientInstruction
Definition	Instructions in terms that are understood by the patient or consumer.
Cardinality	0...1
Type	string
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXO-7 rim: .text
MedicationStatement.dosage.timing
Definition	When medication should be administered.
Cardinality	0...1
Type	Timing
Summary	True
Requirements	The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments	This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: .effectiveTime
MedicationStatement.dosage.asNeeded[x]
Definition	Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Cardinality	0...1
Type	boolean
Binding	A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. SNOMEDCTMedicationAsNeededReasonCodes (example)
Summary	True
Comments	Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: TQ1-9 rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
MedicationStatement.dosage.site
Definition	Body site to administer to.
Cardinality	1...1
Type	CodeableConcept
Binding	A coded concept describing the site location the medicine enters into or onto the body. ssr-eye-body-site (required)
Summary	True
Requirements	A coded specification of the anatomic site where the medication first enters the body.
Comments	If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXR-2 rim: .approachSiteCode
MedicationStatement.dosage.site.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationStatement.dosage.site.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationStatement.dosage.site.coding
Definition	A reference to a code defined by a terminology system.
Cardinality	1...*
Type	Coding
Summary	True
Requirements	Allows for alternative encodings within a code system, and translations to other code systems.
Comments	Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationStatement.dosage.site.coding.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationStatement.dosage.site.coding.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationStatement.dosage.site.coding.system
Definition	The identification of the code system that defines the meaning of the symbol in the code.
Cardinality	1...1
Type	uri
Summary	True
Requirements	Need to be unambiguous about the source of the definition of the symbol.
Comments	The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationStatement.dosage.site.coding.version
Definition	The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality	0...1
Type	string
Summary	True
Comments	Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationStatement.dosage.site.coding.code
Definition	A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality	1...1
Type	code
Summary	True
Requirements	Need to refer to a particular code in the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationStatement.dosage.site.coding.display
Definition	A representation of the meaning of the code in the system, following the rules of the system.
Cardinality	0...1
Type	string
Summary	True
Requirements	Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationStatement.dosage.site.coding.userSelected
Definition	Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality	0...1
Type	boolean
Summary	True
Requirements	This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Comments	Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationStatement.dosage.site.text
Definition	A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality	0...1
Type	string
Summary	True
Requirements	The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments	Very often the text is the same as a displayName of one of the codings.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
MedicationStatement.dosage.route
Definition	How drug should enter body.
Cardinality	0...1
Type	CodeableConcept
Binding	A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example)
Summary	True
Requirements	A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXR-1 rim: .routeCode
MedicationStatement.dosage.method
Definition	Technique for administering medication.
Cardinality	0...1
Type	CodeableConcept
Binding	A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)
Summary	True
Requirements	A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.
Comments	Terminologies used often pre-coordinate this term with the route and or form of administration.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXR-4 rim: .doseQuantity
MedicationStatement.dosage.doseAndRate
Definition	The amount of medication administered.
Cardinality	0...*
Type	Element
Summary	True
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: TQ1-2
MedicationStatement.dosage.doseAndRate.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationStatement.dosage.doseAndRate.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationStatement.dosage.doseAndRate.type
Definition	The kind of dose or rate specified, for example, ordered or calculated.
Cardinality	0...1
Type	CodeableConcept
Binding	The kind of dose or rate specified. DoseAndRateType (example)
Summary	True
Requirements	If the type is not populated, assume to be "ordered".
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXO-21; RXE-23
MedicationStatement.dosage.doseAndRate.dose[x]
Definition	Amount of medication per dose.
Cardinality	1...1
Type	SimpleQuantity
Summary	True
Requirements	The amount of therapeutic or other substance given at one administration event.
Comments	Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXO-2, RXE-3 rim: .doseQuantity
MedicationStatement.dosage.doseAndRate.dose[x].id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
MedicationStatement.dosage.doseAndRate.dose[x].extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a
MedicationStatement.dosage.doseAndRate.dose[x].value
Definition	The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Cardinality	1...1
Type	decimal
Summary	True
Requirements	Precision is handled implicitly in almost all cases of measurement.
Comments	The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
MedicationStatement.dosage.doseAndRate.dose[x].comparator
Definition	Not allowed to be used in this context
Cardinality	0...0
Type	code
Binding	How the Quantity should be understood and represented. QuantityComparator (required)
Modifier	True
Summary	True
Requirements	Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: SN.1 / CQ.1 rim: IVL properties
MedicationStatement.dosage.doseAndRate.dose[x].unit
Definition	A human-readable form of the unit.
Cardinality	0...1
Type	string
Summary	True
Requirements	There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	mg
Mappings	v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
MedicationStatement.dosage.doseAndRate.dose[x].system
Definition	The identification of the system that provides the coded form of the unit.
Cardinality	0...1
Type	uri
Summary	True
Requirements	Need to know the system that defines the coded form of the unit.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	http://unitsofmeasure.org
Mappings	v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
MedicationStatement.dosage.doseAndRate.dose[x].code
Definition	A computer processable form of the unit in some unit representation system.
Cardinality	0...1
Type	code
Summary	True
Requirements	Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Comments	The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Fixed Value	mg
Mappings	v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
MedicationStatement.dosage.doseAndRate.rate[x]
Definition	Amount of medication per unit of time.
Cardinality	0...1
Type	Ratio
Summary	True
Requirements	Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.
Comments	It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXE22, RXE23, RXE-24 rim: .rateQuantity
MedicationStatement.dosage.maxDosePerPeriod
Definition	Upper limit on medication per unit of time.
Cardinality	0...1
Type	Ratio
Summary	True
Requirements	The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.
Comments	This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	v2: RXO-23, RXE-19 rim: .maxDoseQuantity
MedicationStatement.dosage.maxDosePerAdministration
Definition	Upper limit on medication per administration.
Cardinality	0...1
Type	SimpleQuantity
Summary	True
Requirements	The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.
Comments	This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: not supported
MedicationStatement.dosage.maxDosePerLifetime
Definition	Upper limit on medication per lifetime of the patient.
Cardinality	0...1
Type	SimpleQuantity
Summary	True
Requirements	The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: not supported

MedicationStatement		0..*
MedicationStatement.id	string	0..1
MedicationStatement.meta	Meta	0..1
MedicationStatement.implicitRules	uri	0..1
MedicationStatement.language	code	0..1
MedicationStatement.text	Narrative	0..1
MedicationStatement.contained	Resource	0..*
MedicationStatement.extension	Extension	0..*
MedicationStatement.modifierExtension	Extension	0..*
MedicationStatement.identifier	Identifier	0..*
MedicationStatement.basedOn	Reference(MedicationRequest \| CarePlan \| ServiceRequest)	0..*
MedicationStatement.partOf	Reference(MedicationAdministration \| MedicationDispense \| MedicationStatement \| Procedure \| Observation)	0..*
MedicationStatement.status	code	1..1
MedicationStatement.statusReason	CodeableConcept	0..*
MedicationStatement.category	CodeableConcept	0..1
MedicationStatement.medication[x]	CodeableConcept	1..1
MedicationStatement.medication[x].id	string	0..1
MedicationStatement.medication[x].extension	Extension	0..*
MedicationStatement.medication[x].coding	Coding	1..*
MedicationStatement.medication[x].coding.id	string	0..1
MedicationStatement.medication[x].coding.extension	Extension	0..*
MedicationStatement.medication[x].coding.system	uri	1..1
MedicationStatement.medication[x].coding.version	string	0..1
MedicationStatement.medication[x].coding.code	code	1..1
MedicationStatement.medication[x].coding.display	string	0..1
MedicationStatement.medication[x].coding.userSelected	boolean	0..1
MedicationStatement.medication[x].text	string	0..1
MedicationStatement.subject	Reference(SSRPatient)	1..1
MedicationStatement.context	Reference(SSREncounter)	0..1
MedicationStatement.effective[x]	dateTime, Period	0..1
MedicationStatement.dateAsserted	dateTime	0..1
MedicationStatement.informationSource	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Organization)	0..1
MedicationStatement.derivedFrom	Reference(Resource)	0..*
MedicationStatement.reasonCode	CodeableConcept	0..*
MedicationStatement.reasonReference	Reference(Condition \| Observation \| DiagnosticReport)	0..*
MedicationStatement.note	Annotation	0..*
MedicationStatement.dosage	Dosage	1..*
MedicationStatement.dosage.id	string	0..1
MedicationStatement.dosage.extension	Extension	0..*
MedicationStatement.dosage.modifierExtension	Extension	0..*
MedicationStatement.dosage.sequence	integer	0..1
MedicationStatement.dosage.text	string	0..1
MedicationStatement.dosage.additionalInstruction	CodeableConcept	0..*
MedicationStatement.dosage.patientInstruction	string	0..1
MedicationStatement.dosage.timing	Timing	0..1
MedicationStatement.dosage.asNeeded[x]	boolean, CodeableConcept	0..1
MedicationStatement.dosage.site	CodeableConcept	1..1
MedicationStatement.dosage.site.id	string	0..1
MedicationStatement.dosage.site.extension	Extension	0..*
MedicationStatement.dosage.site.coding	Coding	1..*
MedicationStatement.dosage.site.coding.id	string	0..1
MedicationStatement.dosage.site.coding.extension	Extension	0..*
MedicationStatement.dosage.site.coding.system	uri	1..1
MedicationStatement.dosage.site.coding.version	string	0..1
MedicationStatement.dosage.site.coding.code	code	1..1
MedicationStatement.dosage.site.coding.display	string	0..1
MedicationStatement.dosage.site.coding.userSelected	boolean	0..1
MedicationStatement.dosage.site.text	string	0..1
MedicationStatement.dosage.route	CodeableConcept	0..1
MedicationStatement.dosage.method	CodeableConcept	0..1
MedicationStatement.dosage.doseAndRate	Element	0..*
MedicationStatement.dosage.doseAndRate.id	string	0..1
MedicationStatement.dosage.doseAndRate.extension	Extension	0..*
MedicationStatement.dosage.doseAndRate.type	CodeableConcept	0..1
MedicationStatement.dosage.doseAndRate.dose[x]	SimpleQuantity	1..1
MedicationStatement.dosage.doseAndRate.dose[x].id	string	0..1
MedicationStatement.dosage.doseAndRate.dose[x].extension	Extension	0..*
MedicationStatement.dosage.doseAndRate.dose[x].value	decimal	1..1
MedicationStatement.dosage.doseAndRate.dose[x].comparator	code	0..0
MedicationStatement.dosage.doseAndRate.dose[x].unit	string	0..1
MedicationStatement.dosage.doseAndRate.dose[x].system	uri	0..1
MedicationStatement.dosage.doseAndRate.dose[x].code	code	0..1
MedicationStatement.dosage.doseAndRate.rate[x]	Ratio, Range, SimpleQuantity	0..1
MedicationStatement.dosage.maxDosePerPeriod	Ratio	0..1
MedicationStatement.dosage.maxDosePerAdministration	SimpleQuantity	0..1
MedicationStatement.dosage.maxDosePerAdministration.id	string	0..1
MedicationStatement.dosage.maxDosePerAdministration.extension	Extension	0..*
MedicationStatement.dosage.maxDosePerAdministration.value	decimal	0..1
MedicationStatement.dosage.maxDosePerAdministration.comparator	code	0..0
MedicationStatement.dosage.maxDosePerAdministration.unit	string	0..1
MedicationStatement.dosage.maxDosePerAdministration.system	uri	0..1
MedicationStatement.dosage.maxDosePerAdministration.code	code	0..1
MedicationStatement.dosage.maxDosePerLifetime	SimpleQuantity	0..1
MedicationStatement.dosage.maxDosePerLifetime.id	string	0..1
MedicationStatement.dosage.maxDosePerLifetime.extension	Extension	0..*
MedicationStatement.dosage.maxDosePerLifetime.value	decimal	0..1
MedicationStatement.dosage.maxDosePerLifetime.comparator	code	0..0
MedicationStatement.dosage.maxDosePerLifetime.unit	string	0..1
MedicationStatement.dosage.maxDosePerLifetime.system	uri	0..1
MedicationStatement.dosage.maxDosePerLifetime.code	code	0..1