<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="ext-sub-dosage-step" />
  <language value="en-US" />
  <url value="http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-step" />
  <version value="0.20.0" />
  <name value="SubDosageStep" />
  <title value="Ext: Sub Dosage Step" />
  <status value="active" />
  <date value="2026-01-11" />
  <publisher value="Israel Core Team" />
  <contact>
    <telecom>
      <system value="email" />
      <value value="tal.primak@moh.gov.il" />
    </telecom>
  </contact>
  <description value="Indicates whether a dosage decomposed into steps of sub-dosage timings" />
  <fhirVersion value="4.0.1" />
  <mapping>
    <identity value="rim" />
    <uri value="http://hl7.org/v3" />
    <name value="RIM Mapping" />
  </mapping>
  <kind value="complex-type" />
  <abstract value="false" />
  <context>
    <type value="element" />
    <expression value="Dosage" />
  </context>
  <type value="Extension" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" />
  <derivation value="constraint" />
  <snapshot>
    <element id="Extension">
      <path value="Extension" />
      <short value="Ext: Sub Dosage Step" />
      <definition value="Indicates whether a dosage decomposed into steps of sub-dosage timings" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <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(.), 'value')])" />
        <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="Extension.id">
      <path value="Extension.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="Extension.extension">
      <path value="Extension.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="0" />
      <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(.), 'value')])" />
        <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="Extension.url">
      <path value="Extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-step" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]" />
      <short value="How the medication is/was taken or should be taken" />
      <definition value="Indicates how the medication is/was taken or should be taken by the patient." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Dosage" />
        <profile value="http://fhir.health.gov.il/StructureDefinition/il-core-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>
      <constraint>
        <key value="il-core-dosage-ext" />
        <severity value="error" />
        <human value="If extension ext-sub-dosage-step is used, it must appear at least twice" />
        <expression value="extension.where(url = 'http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-step').count() = 0 or extension.where(url = 'http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-step').count() &gt;= 2" />
        <source value="http://fhir.health.gov.il/StructureDefinition/il-core-dosage" />
      </constraint>
      <constraint>
        <key value="il-dosage-no-parent-dose-when-substeps" />
        <severity value="error" />
        <human value="If ext-sub-dosage-step extension is present on Dosage, doseAndRate SHALL NOT be present on the parent Dosage." />
        <expression value="extension.where(url = 'http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-step').exists()&#xD;&#xA;    implies&#xD;&#xA;  doseAndRate.empty()" />
        <source value="http://fhir.health.gov.il/StructureDefinition/il-core-dosage" />
      </constraint>
      <constraint>
        <key value="il-dosage-no-parent-asneeded-when-substeps-have" />
        <severity value="error" />
        <human value="If any sub-dosage step has asNeeded, the parent Dosage SHALL NOT define asNeeded." />
        <expression value="extension.where(url = 'http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-step').valueDosage.asNeeded.exists()&#xD;&#xA;    implies&#xD;&#xA;  asNeeded.empty()" />
        <source value="http://fhir.health.gov.il/StructureDefinition/il-core-dosage" />
      </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=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" />
      </mapping>
    </element>
    <element id="Extension.value[x].id">
      <path value="Extension.value[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="Extension.value[x].extension">
      <path value="Extension.value[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(.), 'value')])" />
        <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="Extension.value[x].modifierExtension">
      <path value="Extension.value[x].modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <ordered value="false" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.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(.), 'value')])" />
        <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="Extension.value[x].sequence">
      <path value="Extension.value[x].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="Extension.value[x].text">
      <path value="Extension.value[x].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>
      <mustSupport value="true" />
      <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="Extension.value[x].additionalInstruction">
      <path value="Extension.value[x].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="extensible" />
        <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="Extension.value[x].patientInstruction">
      <path value="Extension.value[x].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="Extension.value[x].timing">
      <path value="Extension.value[x].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'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="Extension.value[x].asNeeded[x]">
      <path value="Extension.value[x].asNeeded[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <ordered value="false" />
        <rules value="open" />
      </slicing>
      <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="Extension.value[x].asNeeded[x]:asNeededCodeableConcept">
      <path value="Extension.value[x].asNeeded[x]" />
      <sliceName value="asNeededCodeableConcept" />
      <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="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="extensible" />
        <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="Extension.value[x].site">
      <path value="Extension.value[x].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="0" />
      <max value="0" />
      <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="extensible" />
        <description value="A coded concept describing the site location the medicine enters into or onto the body." />
        <valueSet value="http://hl7.org/fhir/ValueSet/approach-site-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-2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".approachSiteCode" />
      </mapping>
    </element>
    <element id="Extension.value[x].route">
      <path value="Extension.value[x].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's body." />
      <min value="0" />
      <max value="0" />
      <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="extensible" />
        <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="Extension.value[x].method">
      <path value="Extension.value[x].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="0" />
      <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="preferred" />
        <description value="A coded concept describing the technique by which the medicine is administered." />
        <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-medication-administration-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="v2" />
        <map value="RXR-4" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".doseQuantity" />
      </mapping>
    </element>
    <element id="Extension.value[x].doseAndRate">
      <path value="Extension.value[x].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="Extension.value[x].doseAndRate.id">
      <path value="Extension.value[x].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="Extension.value[x].doseAndRate.extension">
      <path value="Extension.value[x].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(.), 'value')])" />
        <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="Extension.value[x].doseAndRate.type">
      <path value="Extension.value[x].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="extensible" />
        <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="Extension.value[x].doseAndRate.dose[x]">
      <path value="Extension.value[x].doseAndRate.dose[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <ordered value="false" />
        <rules value="open" />
      </slicing>
      <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="0" />
      <max value="1" />
      <base>
        <path value="Dosage.doseAndRate.dose[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <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="RXO-2, RXE-3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".doseQuantity" />
      </mapping>
    </element>
    <element id="Extension.value[x].doseAndRate.dose[x]:doseQuantity">
      <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="Extension.value[x].doseAndRate.dose[x]" />
      <sliceName value="doseQuantity" />
      <short value="A fixed quantity (no comparator)" />
      <definition value="The comparator is not used on a SimpleQuantity" />
      <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 amount of therapeutic or other substance given at one administration event." />
      <min value="0" />
      <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" />
      <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" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://fhir.health.gov.il/ValueSet/il-core-units-of-measure" />
        </extension>
        <strength value="extensible" />
        <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure" />
      </binding>
      <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>
      <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>
    </element>
    <element id="Extension.value[x].doseAndRate.dose[x]:doseRange">
      <path value="Extension.value[x].doseAndRate.dose[x]" />
      <sliceName value="doseRange" />
      <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="0" />
      <max value="1" />
      <base>
        <path value="Dosage.doseAndRate.dose[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Range" />
      </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-2, RXE-3" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".doseQuantity" />
      </mapping>
    </element>
    <element id="Extension.value[x].doseAndRate.dose[x]:doseRange.id">
      <path value="Extension.value[x].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="Extension.value[x].doseAndRate.dose[x]:doseRange.extension">
      <path value="Extension.value[x].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(.), 'value')])" />
        <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="Extension.value[x].doseAndRate.dose[x]:doseRange.low">
      <path value="Extension.value[x].doseAndRate.dose[x].low" />
      <short value="Low limit" />
      <definition value="The low limit. The boundary is inclusive." />
      <comment value="If the low element is missing, the low boundary is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Range.low" />
        <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="v2" />
        <map value="NR.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./low" />
      </mapping>
    </element>
    <element id="Extension.value[x].doseAndRate.dose[x]:doseRange.low.id">
      <path value="Extension.value[x].doseAndRate.dose[x].low.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="Extension.value[x].doseAndRate.dose[x]:doseRange.low.extension">
      <path value="Extension.value[x].doseAndRate.dose[x].low.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(.), 'value')])" />
        <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="Extension.value[x].doseAndRate.dose[x]:doseRange.low.value">
      <path value="Extension.value[x].doseAndRate.dose[x].low.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="Extension.value[x].doseAndRate.dose[x]:doseRange.low.comparator">
      <path value="Extension.value[x].doseAndRate.dose[x].low.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="Extension.value[x].doseAndRate.dose[x]:doseRange.low.unit">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="Extension.value[x].doseAndRate.dose[x].low.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="Extension.value[x].doseAndRate.dose[x]:doseRange.low.system">
      <path value="Extension.value[x].doseAndRate.dose[x].low.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="Extension.value[x].doseAndRate.dose[x]:doseRange.low.code">
      <path value="Extension.value[x].doseAndRate.dose[x].low.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" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://fhir.health.gov.il/ValueSet/il-core-units-of-measure" />
        </extension>
        <strength value="extensible" />
        <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure" />
      </binding>
      <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="Extension.value[x].doseAndRate.dose[x]:doseRange.high">
      <path value="Extension.value[x].doseAndRate.dose[x].high" />
      <short value="High limit" />
      <definition value="The high limit. The boundary is inclusive." />
      <comment value="If the high element is missing, the high boundary is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Range.high" />
        <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="v2" />
        <map value="NR.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./high" />
      </mapping>
    </element>
    <element id="Extension.value[x].doseAndRate.dose[x]:doseRange.high.id">
      <path value="Extension.value[x].doseAndRate.dose[x].high.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="Extension.value[x].doseAndRate.dose[x]:doseRange.high.extension">
      <path value="Extension.value[x].doseAndRate.dose[x].high.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(.), 'value')])" />
        <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="Extension.value[x].doseAndRate.dose[x]:doseRange.high.value">
      <path value="Extension.value[x].doseAndRate.dose[x].high.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="Extension.value[x].doseAndRate.dose[x]:doseRange.high.comparator">
      <path value="Extension.value[x].doseAndRate.dose[x].high.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="Extension.value[x].doseAndRate.dose[x]:doseRange.high.unit">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="Extension.value[x].doseAndRate.dose[x].high.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="Extension.value[x].doseAndRate.dose[x]:doseRange.high.system">
      <path value="Extension.value[x].doseAndRate.dose[x].high.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="Extension.value[x].doseAndRate.dose[x]:doseRange.high.code">
      <path value="Extension.value[x].doseAndRate.dose[x].high.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" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://fhir.health.gov.il/ValueSet/il-core-units-of-measure" />
        </extension>
        <strength value="extensible" />
        <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure" />
      </binding>
      <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="Extension.value[x].doseAndRate.rate[x]">
      <path value="Extension.value[x].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.&#xD;&#xD;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." />
      <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'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="Extension.value[x].maxDosePerPeriod">
      <path value="Extension.value[x].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="Extension.value[x].maxDosePerAdministration">
      <path value="Extension.value[x].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" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://fhir.health.gov.il/ValueSet/il-core-units-of-measure" />
        </extension>
        <strength value="extensible" />
        <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure" />
      </binding>
      <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="Extension.value[x].maxDosePerLifetime">
      <path value="Extension.value[x].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" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://fhir.health.gov.il/ValueSet/il-core-units-of-measure" />
        </extension>
        <strength value="extensible" />
        <valueSet value="http://fhir.health.gov.il/ValueSet/il-core-common-units-of-measure" />
      </binding>
      <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>
  </snapshot>
  <differential>
    <element id="Extension">
      <path value="Extension" />
      <short value="Ext: Sub Dosage Step" />
      <definition value="Indicates whether a dosage decomposed into steps of sub-dosage timings" />
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension" />
      <max value="0" />
    </element>
    <element id="Extension.url">
      <path value="Extension.url" />
      <fixedUri value="http://fhir.health.gov.il/StructureDefinition/ext-sub-dosage-step" />
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]" />
      <type>
        <code value="Dosage" />
        <profile value="http://fhir.health.gov.il/StructureDefinition/il-core-dosage" />
      </type>
    </element>
    <element id="Extension.value[x].site">
      <path value="Extension.value[x].site" />
      <max value="0" />
    </element>
    <element id="Extension.value[x].route">
      <path value="Extension.value[x].route" />
      <max value="0" />
    </element>
    <element id="Extension.value[x].method">
      <path value="Extension.value[x].method" />
      <max value="0" />
    </element>
  </differential>
</StructureDefinition>