<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="MedicationRequest-verto" />
  <url value="http://verto.ca/fhir/StructureDefinition/MedicationRequest-custom" />
  <version value="1.0.0" />
  <name value="MedicationRequest" />
  <title value="Verto's MedicationRequest Profile" />
  <status value="active" />
  <experimental value="true" />
  <date value="2025-01-13" />
  <publisher value="Verto Health" />
  <description value="Medication Request constrained by Verto's Digital Twin, based on the International and Canadian Patient Summaries" />
  <fhirVersion value="5.0.0" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="MedicationRequest" />
  <baseDefinition value="http://hl7.org/fhir/R4/StructureDefinition/MedicationRequest" />
  <derivation value="constraint" />
  <snapshot />
  <differential>
    <element id="MedicationRequest">
      <path value="MedicationRequest" />
      <short value="Verto's MedicationRequest Profile" />
      <definition value="An order or request for both supply of the medication and the instruction for administration of the medication to a patient.." />
      <type>
        <code value="MedicationRequest" />
      </type>
    </element>
    <element id="MedicationRequest.id">
      <path value="MedicationRequest.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="The id is auto-generated as a UUID by Verto when the resource is created, and is used as an internal identifier within the Digital Twin. It has no business meaning outside of the Digital Twin's context." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.identifier">
      <path value="MedicationRequest.identifier" />
      <short value="External ids from the source system of record" />
      <definition value="Identifiers associated with this medication request that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server." />
      <comment value="This is a business identifier, not a resource identifier." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationRequest.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.status">
      <path value="MedicationRequest.status" />
      <short value="The current state of the order" />
      <definition value="A code specifying the current state of the order.  Generally, this will be active or completed state." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationRequestStatus" />
        </extension>
        <strength value="required" />
        <description value="A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription." />
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-status|4.0.1" />
      </binding>
    </element>
    <element id="MedicationRequest.statusReason">
      <path value="MedicationRequest.statusReason" />
      <short value="Reason for current status" />
      <definition value="Captures the reason for the current state of the MedicationRequest." />
      <comment value="This is generally only used for &quot;exception&quot; statuses such as &quot;suspended&quot; or &quot;cancelled&quot;. The reason why the MedicationRequest was created at all is captured in reasonCode, not here." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.statusReason" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationRequestStatusReason" />
        </extension>
        <strength value="example" />
        <description value="Identifies the reasons for a given status." />
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-status-reason" />
      </binding>
    </element>
    <element id="MedicationRequest.intent">
      <path value="MedicationRequest.intent" />
      <short value="Whether the request is a proposal, plan, or an original order." />
      <definition value="Whether the request is a proposal, plan, or an original order." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.intent" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationRequestIntent" />
        </extension>
        <strength value="required" />
        <description value="The kind of medication order." />
        <valueSet value="http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1" />
      </binding>
    </element>
    <element id="MedicationRequest.priority">
      <path value="MedicationRequest.priority" />
      <short value="How quickly the request should be addressed" />
      <definition value="Indicates how quickly the Medication Request should be addressed with respect to other requests." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.priority" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationRequestPriority" />
        </extension>
        <strength value="required" />
        <description value="Identifies the level of importance to be assigned to actioning the request." />
        <valueSet value="http://hl7.org/fhir/ValueSet/request-priority|4.0.1" />
      </binding>
    </element>
    <element id="MedicationRequest.doNotPerform">
      <path value="MedicationRequest.doNotPerform" />
      <short value="True if request is prohibiting action" />
      <definition value="If true indicates that the provider is asking for the medication request not to occur." />
      <comment value="If do not perform is not specified, the request is a positive request e.g. &quot;do perform&quot;." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.doNotPerform" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <isModifier value="true" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.medication">
      <path value="MedicationRequest.medication" />
      <short value="Medication to be taken" />
      <definition value="Provides a link to the record in the medication table which represents the medication to be taken." />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="CodeableReference" />
        <targetProfile value="http://verto.ca/fhir/StructureDefinition/medication-custom" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.subject">
      <path value="MedicationRequest.subject" />
      <short value="Who the medication request is for" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.subject" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.informationSource">
      <path value="MedicationRequest.informationSource" />
      <short value="The person or organization who provided information about this request, if the source is someone other than the requestor" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationRequest.informationSource" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/patient" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/practitioner" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/organization" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.supportingInformation">
      <path value="MedicationRequest.supportingInformation" />
      <short value="The information (specifically, a past medication statement) to support this new request" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.supportingInformation" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.encounter">
      <path value="MedicationRequest.encounter" />
      <short value="The encounter the medication request occurred under" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.encounter" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/encounter" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.authoredOn">
      <path value="MedicationRequest.authoredOn" />
      <short value="When request was initially authored" />
      <definition value="The date (and perhaps time) when the prescription was initially written or authored on." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.authoredOn" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.requester">
      <path value="MedicationRequest.requester" />
      <short value="The persom who made the request" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.requester" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/practitioner" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/organization" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/patient" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.performer">
      <path value="MedicationRequest.performer" />
      <short value="Intended performer of administration" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.performer" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/practitioner" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/organization" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/patient" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.performerType">
      <path value="MedicationRequest.performerType" />
      <short value="Desired kind of performer for the medication administration" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="Identifies the type of individual that is desired to administer the medication." />
        <valueSet value="http://hl7.org/fhir/ValueSet/performer-role" />
      </binding>
    </element>
    <element id="MedicationRequest.recorder">
      <path value="MedicationRequest.recorder" />
      <short value="Person who entered the request" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.recorder" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/practitioner" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.reasonCode">
      <path value="MedicationRequest.reasonCode" />
      <short value="Reason or indication for ordering or not ordering the medication" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
      <binding>
        <strength value="example" />
        <description value="Identifies the type of individual that is desired to administer the medication." />
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-code" />
      </binding>
    </element>
    <element id="MedicationRequest.reasonReference">
      <path value="MedicationRequest.reasonReference" />
      <short value="Condition or Observation that supports why the prescription is being written" />
      <comment value="Verto's digital twin constrains this field to only one of both the Condition or the Observation resource." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationRequest.reasonReference" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/practitioner" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/organization" />
        <targetProfile value="https://hl7.org/fhir/StructureDefinition/patient" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.groupIdentifier">
      <path value="MedicationRequest.groupIdentifier" />
      <short value="Composite request this is part of" />
      <definition value="A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition or prescription." />
      <requirements value="Requests are linked either by a &quot;basedOn&quot; relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="MedicationRequest.groupIdentifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.note">
      <path value="MedicationRequest.note" />
      <short value="Information about the prescription" />
      <definition value="Extra information about the prescription that could not be conveyed by the other attributes." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="MedicationRequest.note" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Annotation" />
      </type>
    </element>
    <element id="MedicationRequest.dosageInstruction">
      <path value="MedicationRequest.dosageInstruction" />
      <short value="How the medication should be taken" />
      <min value="0" />
      <max value="*" />
      <type>
        <code value="Dosage" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.dosageInstruction.id">
      <path value="MedicationRequest.dosageInstruction.id" />
      <short value="Unique, Verto-specific id for inter-element referencing" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="string" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.dosageInstruction.sequence">
      <path value="MedicationRequest.dosageInstruction.sequence" />
      <short value="The order of the dosage instructions" />
      <definition value="Indicates the order in which the dosage instructions should be applied or interpreted." />
      <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>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.dosageInstruction.text">
      <path value="MedicationRequest.dosageInstruction.text" />
      <short value="Free text dosage instructions e.g. SIG" />
      <definition value="Free text dosage instructions e.g. SIG" />
      <comment value="Free text dosage instructions can be used for cases where the instructions are too complex to code." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <mustSupport value="false" />
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.dosageInstruction.additionalInstruction">
      <path value="MedicationRequest.dosageInstruction.additionalInstruction" />
      <short value="Supplemental instruction or warnings to the patient - e.g. &quot;take with meals&quot;" />
      <definition value="Supplemental instructions to the patient on how to take the medication or warnings for the patient about the medication." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Dosage.additionalInstruction" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdditionalInstruction" />
        </extension>
        <strength value="example" />
        <valueSet value="http://hl7.org/fhir/ValueSet/additional-instruction-codes" />
      </binding>
    </element>
    <element id="MedicationRequest.dosageInstruction.patientInstruction">
      <path value="MedicationRequest.dosageInstruction.patientInstruction" />
      <short value="Patient or consumer oriented instructions" />
      <definition value="Instructions in terms that are understood by the patient or consumer." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.patientInstruction" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.dosageInstruction.timing">
      <path value="MedicationRequest.dosageInstruction.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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.timing" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Timing" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.dosageInstruction.asNeeded[x]">
      <path value="MedicationRequest.dosageInstruction.asNeeded[x]" />
      <short value="Take &quot;as needed&quot; (for x)" />
      <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept)." />
      <comment value="Can express &quot;as needed&quot; without a reason by setting the Boolean = True.  In this case the CodeableConcept is not populated.  Or you can express &quot;as needed&quot; with a reason by including the CodeableConcept.  In this case the Boolean is assumed to be True.  If you set the Boolean to False, then the dose is given according to the schedule and is not &quot;prn&quot; or &quot;as needed&quot;." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.asNeeded[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isModifier value="false" />
      <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." />
        <valueSet value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason" />
      </binding>
    </element>
    <element id="MedicationRequest.dosageInstruction.site">
      <path value="MedicationRequest.dosageInstruction.site" />
      <short value="Body site to administer to" />
      <definition value="Anatomic site where the medication should be administered." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.site" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationSite" />
        </extension>
        <strength value="example" />
        <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>
    </element>
    <element id="MedicationRequest.dosageInstruction.route">
      <path value="MedicationRequest.dosageInstruction.route" />
      <short value="How drug should enter body" />
      <definition value="How drug should enter body." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.route" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
        <profile value="http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips" />
      </type>
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <strength value="preferred" />
        <description value="EDQM Standards Terms" />
        <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/medicine-route-of-administration" />
      </binding>
    </element>
    <element id="MedicationRequest.dosageInstruction.method">
      <path value="MedicationRequest.dosageInstruction.method" />
      <short value="Technique for administering medication" />
      <definition value="Technique for administering medication." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.method" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <isModifier value="false" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MedicationAdministrationMethod" />
        </extension>
        <strength value="example" />
        <description value="A coded concept describing the technique by which the medicine is administered." />
        <valueSet value="http://hl7.org/fhir/ValueSet/administration-method-codes" />
      </binding>
    </element>
    <element id="MedicationRequest.dosageInstruction.doseAndRate">
      <path value="MedicationRequest.dosageInstruction.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>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.dosageInstruction.doseAndRate.id">
      <path value="MedicationRequest.dosageInstruction.doseAndRate.id" />
      <short value="Unique, Verto-specific id for inter-element referencing" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <isModifier value="false" />
      <isSummary value="false" />
    </element>
    <element id="MedicationRequest.dosageInstruction.doseAndRate.dose[x]">
      <path value="MedicationRequest.dosageInstruction.doseAndRate.dose[x]" />
      <short value="Amount of medication per dose" />
      <definition value="Amount of medication per dose." />
      <comment value="Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ." />
      <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>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.dosageInstruction.doseAndRate.rate[x]">
      <path value="MedicationRequest.dosageInstruction.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." />
      <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>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.dosageInstruction.maxDosePerPeriod">
      <path value="MedicationRequest.dosageInstruction.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;." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Dosage.maxDosePerPeriod" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Ratio" />
      </type>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.dosageInstruction.maxDosePerAdministration">
      <path value="MedicationRequest.dosageInstruction.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." />
      <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>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
    <element id="MedicationRequest.dosageInstruction.maxDosePerLifetime">
      <path value="MedicationRequest.dosageInstruction.maxDosePerLifetime" />
      <short value="Upper limit on medication per lifetime of the patient" />
      <definition value="Upper limit on medication per lifetime of the patient." />
      <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>
      <isModifier value="false" />
      <isSummary value="true" />
    </element>
  </differential>
</StructureDefinition>