Guías de Implementación FHIR Receta Digital | Ministerio de Salud
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Guías de Implementación FHIR Receta Digital | Ministerio de Salud - Local Development build (v1.1.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MedicationDispenseRD - Detailed Descriptions

Page standards status: Draft Maturity Level: 0

Definitions for the medicationDispense resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationDispense
Definition

Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

ShortDispensing a medication to a named patient
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.id
Definition

Identificador único del Despacho dentro del sistema.


The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortIdentificador único del Despacho dentro del sistema.Logical id of this artifact
Comments

Este es el identificador único del Despacho dentro del sistema. Se espera que el Despacho tenga un identificador único dentro del sistema.


The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeidstring
Is Modifierfalse
Summarytrue
4. MedicationDispense.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..01
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. MedicationDispense.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationDispense.extension
Definition

Extensión utilizada para registrar los lotes del medicamento entregado. Puede haber múltiples extensiones si se usaron varios lotes en el despacho.


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortLote de medicamento entregadoAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. MedicationDispense.extension.extension
Definition

Contiene dos subextensiones: una para el número de lote y otra para la cantidad entregada de ese lote.


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.

ShortNúmero y cantidad del loteAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control20..2*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on MedicationDispense.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 12. MedicationDispense.extension.extension.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on MedicationDispense.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 14. MedicationDispense.extension.extension.url
      Definition

      Indica si la subextensión corresponde al número de lote o a la cantidad entregada del lote.


      Source of the definition for the extension code - a logical name or a URL.

      ShortTipo de valor registradoidentifies the meaning of the extension
      Comments

      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.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      16. MedicationDispense.extension.extension.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control0..1
      TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on MedicationDispense.extension.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 18. MedicationDispense.extension.extension.value[x]:valueString
        Slice NamevalueString
        Definition

        Código o identificador del lote del medicamento entregado.


        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortNúmero de loteValue of extension
        Control0..1
        Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. MedicationDispense.extension.extension.value[x]:valueInteger
        Slice NamevalueInteger
        Definition

        Cantidad del medicamento entregado correspondiente al lote identificado.


        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortCantidad del loteValue of extension
        Control0..1
        Typeinteger, date, Meta, Address, Attachment, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. MedicationDispense.extension.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        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.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        24. MedicationDispense.extension.value[x]
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortValue of extension
        Control0..01
        TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. MedicationDispense.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        28. MedicationDispense.status
        Definition

        Determina el estado del despacho conforme a los códigos definidos por el estándar


        A code specifying the state of the set of dispense events.

        ShortEntregada | Entregada Parcial | Rechazadapreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
        Comments

        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Control1..1
        BindingThe codes SHALL be taken from MedicationDispense Status Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

        Códigos requeridos por FHIR


        A coded concept specifying the state of the dispense event.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. MedicationDispense.medication[x]
        Definition

        La referencia al medicamento que está asociado con el despacho.


        Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

        ShortReferencia al medicamento despachadoWhat medication was supplied
        Comments

        If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

        Control1..1
        TypeReference(Medication, Medication), CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. MedicationDispense.medication[x].reference
        Definition

        Referencia al recurso del medicamento asociado con el despacho.


        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortReferencia al medicamentoLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. MedicationDispense.medication[x].display
        Definition

        Nombre del medicamento asociado con el despacho.


        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortNombre del medicamentoText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. MedicationDispense.subject
        Definition

        La referencia al paciente que está asociado con el despacho.


        A link to a resource representing the person or the group to whom the medication will be given.

        ShortReferencia al paciente asociadoWho the dispense is for
        Comments

        SubstanceAdministration->subject->Patient.

        Control10..1
        TypeReference(Patient, Patient, Group)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. MedicationDispense.subject.reference
        Definition

        Referencia al recurso del paciente asociado con el despacho.


        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortReferencia al pacienteLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. MedicationDispense.subject.display
        Definition

        Nombre del paciente asociado con el despacho.


        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortNombre del pacienteText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. MedicationDispense.performer
        Definition

        La referencia al profesional, institución o persona relacionada que se realizó el despacho.


        Indicates who or what performed the event.

        ShortReferencia al profesional, institución o persona relacionada asociadoWho performed event
        Control30..3*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. MedicationDispense.performer.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        46. MedicationDispense.performer.actor
        Definition

        La referencia al profesional, institución o persona relacionada que está asociado con el despacho.


        The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

        ShortReferencia al profesional, institución o persona relacionada asociadoIndividual who was performing
        Control1..1
        TypeReference(Practitioner, Organization, RelatedPerson, Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. MedicationDispense.performer.actor.reference
        Definition

        Referencia al recurso del profesional, institución o persona relacionada asociado con el despacho.


        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortReferencia al profesional, institución o persona relacionadaLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. MedicationDispense.performer.actor.display
        Definition

        Nombre del profesional, institución o persona relacionada asociado con el despacho.


        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortNombre del profesional, institución o persona relacionadaText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. MedicationDispense.authorizingPrescription
        Definition

        Referencia al recurso de la prescripción (MedicationRequest) que autoriza este despacho.


        Indicates the medication order that is being dispensed against.

        ShortReferencia a la prescripciónMedication order that authorizes the dispense
        Comments

        Maps to basedOn in Event logical model.

        Control10..1*
        TypeReference(MedicationRequest)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. MedicationDispense.authorizingPrescription.reference
        Definition

        Referencia al recurso MedicationRequest relacionado con este despacho.


        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortReferencia a la prescripciónLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control10..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. MedicationDispense.authorizingPrescription.display
        Definition

        Resumen o nombre descriptivo de la prescripción asociada al despacho.


        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortResumen de la prescripciónText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. MedicationDispense.quantity
        Definition

        Cantidad total del medicamento que fue entregado al paciente en esta dispensación.


        The amount of medication that has been dispensed. Includes unit of measure.

        ShortCantidad despachadaAmount dispensed
        Control10..1
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. MedicationDispense.quantity.value
        Definition

        Número que representa la cantidad del medicamento despachado


        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

        ShortValor numérico de la cantidadNumerical value (with implicit precision)
        Comments

        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

        Control10..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Precision is handled implicitly in almost all cases of measurement.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. MedicationDispense.quantity.comparator
        Definition

        Not allowed to be used in this context


        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

        Short< | <= | >= | > - how to understand the value
        Control0..01
        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

        How the Quantity should be understood and represented.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

        Meaning if MissingIf there is no comparator, then there is no modification of the value
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. MedicationDispense.quantity.unit
        Definition

        Unidad en la que se expresa la cantidad del medicamento


        A human-readable form of the unit.

        ShortUnidad de medidaUnit representation
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. MedicationDispense.daysSupply
        Definition

        Número estimado de días para los que alcanza el medicamento al paciente.


        The amount of medication expressed as a timing amount.

        ShortDuración del tratamientoAmount of medication expressed as a timing amount
        Control0..1
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. MedicationDispense.daysSupply.value
        Definition

        Cantidad de días que cubre el tratamiento con la dosis.


        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

        ShortNúmero de díasNumerical value (with implicit precision)
        Comments

        The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

        Control10..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Precision is handled implicitly in almost all cases of measurement.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. MedicationDispense.daysSupply.comparator
        Definition

        Not allowed to be used in this context


        How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

        Short< | <= | >= | > - how to understand the value
        Control0..01
        BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

        How the Quantity should be understood and represented.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

        Meaning if MissingIf there is no comparator, then there is no modification of the value
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. MedicationDispense.daysSupply.unit
        Definition

        Unidad de medida de tiempo utilizada


        A human-readable form of the unit.

        ShortUnidad de tiempoUnit representation
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. MedicationDispense.whenHandedOver
        Definition

        Fecha en la que se entregó el medicamento al paciente durante esta dispensación.


        The time the dispensed product was provided to the patient or their representative.

        ShortFecha de entregaWhen product was given out
        Control10..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. MedicationDispense.dosageInstruction
        Definition

        Instrucciones detalladas sobre cómo debe administrarse el medicamento entregado al paciente


        Indicates how the medication is to be used by the patient.

        ShortInstrucciones de administración entregadasHow the medication is to be used by the patient or administered by the caregiver
        Comments

        When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

        Control10..1*
        TypeDosage
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. MedicationDispense.dosageInstruction.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        80. MedicationDispense.dosageInstruction.text
        Definition

        Texto en lenguaje natural que describe cómo debe administrarse el medicamento según lo entregado


        Free text dosage instructions e.g. SIG.

        ShortDescripción libre de las instrucciones entregadasFree text dosage instructions e.g. SIG
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. MedicationDispense.dosageInstruction.timing
        Definition

        Define con qué frecuencia y en qué momento del día debe administrarse el medicamento entregado


        When medication should be administered.

        ShortFrecuencia y momento de administración entregadaWhen medication should be administered
        Comments

        This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

        Control10..1
        TypeTiming
        Is Modifierfalse
        Summarytrue
        Requirements

        The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. MedicationDispense.dosageInstruction.timing.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        86. MedicationDispense.dosageInstruction.timing.repeat
        Definition

        Especificación del intervalo de administración del medicamento tal como fue indicado en el despacho


        A set of rules that describe when the event is scheduled.

        ShortPatrón de administración indicadoWhen the event is to occur
        Control10..1
        TypeElement
        Is Modifierfalse
        Summarytrue
        Requirements

        Many timing schedules are determined by regular repetitions.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
        tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
        tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
        tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
        tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
        tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
        tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
        tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
        tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
        tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
        88. MedicationDispense.dosageInstruction.timing.repeat.duration
        Definition

        Tiempo estimado de duración de cada administración del medicamento entregado


        How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

        ShortDuración de cada tomaHow long when it happens
        Comments

        For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

        Control10..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Some activities are not instantaneous and need to be maintained for a period of time.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. MedicationDispense.dosageInstruction.timing.repeat.durationUnit
        Definition

        Unidad de medida para la duración de cada toma del medicamento entregado


        The units of time for the duration, in UCUM units.

        ShortUnidad de duracións | min | h | d | wk | mo | a - unit of time (UCUM)
        Control10..1
        BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
        (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

        A unit of time (units from UCUM).

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        92. MedicationDispense.dosageInstruction.timing.repeat.frequency
        Definition

        Número de veces que se espera que el medicamento entregado sea administrado en un período


        The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

        ShortFrecuencia de administraciónEvent occurs frequency times per period
        Control10..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        94. MedicationDispense.dosageInstruction.timing.repeat.period
        Definition

        Intervalo de tiempo entre cada administración del medicamento entregado


        Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

        ShortPeríodo entre tomasEvent occurs frequency times per period
        Control0..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        96. MedicationDispense.dosageInstruction.timing.repeat.periodUnit
        Definition

        Unidad de tiempo que define el intervalo entre tomas del medicamento entregado


        The units of time for the period in UCUM units.

        ShortUnidad de períodos | min | h | d | wk | mo | a - unit of time (UCUM)
        Control0..1
        BindingThe codes SHALL be taken from UnitsOfTimehttp://hl7.org/fhir/ValueSet/units-of-time|4.0.1
        (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

        A unit of time (units from UCUM).

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Fixed Valued
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        98. MedicationDispense.dosageInstruction.route
        Definition

        Ruta por la cual debe administrarse el medicamento que fue entregado al paciente


        How drug should enter body.

        ShortVía de administraciónHow drug should enter body
        Control10..1
        BindingThe codes SHALL be taken from For example codes, see Listado de vías de administraciónhttp://hl7.org/fhir/ValueSet/route-codes|4.0.1
        (required to https://ministeriodesalud.go.cr/fhir/receta/ValueSet/MedicationAdministrationLine)

        Códigos estándar que representan la vía de administración del medicamento entregado


        A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        100. MedicationDispense.dosageInstruction.route.coding
        Definition

        Código estándar que representa la vía por la cual se debe administrar el medicamento entregado


        A reference to a code defined by a terminology system.

        ShortCodificación de la vía de administraciónCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control10..1*
        TypeCoding
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. MedicationDispense.dosageInstruction.route.coding.system
        Definition

        Sistema que define los códigos para la vía de administración (ej. SNOMED CT)


        The identification of the code system that defines the meaning of the symbol in the code.

        ShortSistema de codificaciónIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. MedicationDispense.dosageInstruction.route.coding.code
        Definition

        Código que representa una vía de administración específica para el medicamento entregado


        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortCódigo de la víaSymbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        106. MedicationDispense.dosageInstruction.route.coding.display
        Definition

        Nombre o descripción legible de la vía de administración del medicamento entregado


        A representation of the meaning of the code in the system, following the rules of the system.

        ShortDescripción de la víaRepresentation defined by the system
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        108. MedicationDispense.dosageInstruction.route.text
        Definition

        Representación textual de la vía de administración del medicamento entregado


        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        ShortTexto de la víaPlain text representation of the concept
        Comments

        Very often the text is the same as a displayName of one of the codings.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        110. MedicationDispense.dosageInstruction.doseAndRate
        Definition

        Información sobre la dosis que debe administrarse del medicamento entregado y la velocidad si aplica


        The amount of medication administered.

        ShortDosis y velocidad administradasAmount of medication administered
        Control10..1*
        TypeElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        112. MedicationDispense.dosageInstruction.doseAndRate.dose[x]
        Definition

        Amount of medication per dose.

        ShortAmount of medication per dose
        Comments

        Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

        Control10..1
        TypeQuantity(SimpleQuantity), Range
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summarytrue
        Requirements

        The amount of therapeutic or other substance given at one administration event.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 114. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity
          Slice NamedoseQuantity
          Definition

          Cantidad específica de medicamento entregado que debe administrarse en cada toma


          Amount of medication per dose.

          ShortCantidad por tomaAmount of medication per dose
          Comments

          Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

          Control10..1
          TypeQuantity(SimpleQuantity, SimpleQuantity), Range
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summarytrue
          Requirements

          The amount of therapeutic or other substance given at one administration event.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
          Definition

          Cantidad numérica de medicamento que fue entregado por toma


          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          ShortValor numérico de la dosisNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

          Control10..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Precision is handled implicitly in almost all cases of measurement.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator
          Definition

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

          Short< | <= | >= | > - how to understand the value
          Control0..01
          BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

          Meaning if MissingIf there is no comparator, then there is no modification of the value
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit
          Definition

          Unidad de medida en la que se expresa la dosis del medicamento entregado (ej. comprimido(s), cápsula(s))


          A human-readable form of the unit.

          ShortUnidad de dosisUnit representation
          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be foundhere

          0. MedicationDispense
          2. MedicationDispense.id
          Definition

          Identificador único del Despacho dentro del sistema.

          ShortIdentificador único del Despacho dentro del sistema.
          Comments

          Este es el identificador único del Despacho dentro del sistema. Se espera que el Despacho tenga un identificador único dentro del sistema.

          4. MedicationDispense.meta
          Control0..0
          6. MedicationDispense.extension
          Definition

          Extensión utilizada para registrar los lotes del medicamento entregado. Puede haber múltiples extensiones si se usaron varios lotes en el despacho.

          ShortLote de medicamento entregado
          Must Supporttrue
          8. MedicationDispense.extension.extension
          Definition

          Contiene dos subextensiones: una para el número de lote y otra para la cantidad entregada de ese lote.

          ShortNúmero y cantidad del lote
          Control2..2
          10. MedicationDispense.extension.extension.extension
          Control0..0
          12. MedicationDispense.extension.extension.url
          Definition

          Indica si la subextensión corresponde al número de lote o a la cantidad entregada del lote.

          ShortTipo de valor registrado
          14. MedicationDispense.extension.extension.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          SlicingThis element introduces a set of slices on MedicationDispense.extension.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 16. MedicationDispense.extension.extension.value[x]:valueString
            Slice NamevalueString
            Definition

            Código o identificador del lote del medicamento entregado.

            ShortNúmero de lote
            Control0..1
            Typestring
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            18. MedicationDispense.extension.extension.value[x]:valueInteger
            Slice NamevalueInteger
            Definition

            Cantidad del medicamento entregado correspondiente al lote identificado.

            ShortCantidad del lote
            Control0..1
            Typeinteger
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            20. MedicationDispense.extension.value[x]
            Control0..0
            22. MedicationDispense.status
            Definition

            Determina el estado del despacho conforme a los códigos definidos por el estándar

            ShortEntregada | Entregada Parcial | Rechazada
            BindingThe codes SHALL be taken from MedicationDispense Status Codes
            (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

            Códigos requeridos por FHIR

            Must Supporttrue
            24. MedicationDispense.medication[x]
            Definition

            La referencia al medicamento que está asociado con el despacho.

            ShortReferencia al medicamento despachado
            TypeReference(Medication), CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Must Supporttrue
            26. MedicationDispense.medication[x].reference
            Definition

            Referencia al recurso del medicamento asociado con el despacho.

            ShortReferencia al medicamento
            Control1..?
            28. MedicationDispense.medication[x].display
            Definition

            Nombre del medicamento asociado con el despacho.

            ShortNombre del medicamento
            30. MedicationDispense.subject
            Definition

            La referencia al paciente que está asociado con el despacho.

            ShortReferencia al paciente asociado
            Control1..?
            TypeReference(Patient)
            Must Supporttrue
            32. MedicationDispense.subject.reference
            Definition

            Referencia al recurso del paciente asociado con el despacho.

            ShortReferencia al paciente
            Control1..?
            34. MedicationDispense.subject.display
            Definition

            Nombre del paciente asociado con el despacho.

            ShortNombre del paciente
            36. MedicationDispense.performer
            Definition

            La referencia al profesional, institución o persona relacionada que se realizó el despacho.

            ShortReferencia al profesional, institución o persona relacionada asociado
            Control3..3
            Must Supporttrue
            38. MedicationDispense.performer.actor
            Definition

            La referencia al profesional, institución o persona relacionada que está asociado con el despacho.

            ShortReferencia al profesional, institución o persona relacionada asociado
            TypeReference(Practitioner, Organization, RelatedPerson)
            40. MedicationDispense.performer.actor.reference
            Definition

            Referencia al recurso del profesional, institución o persona relacionada asociado con el despacho.

            ShortReferencia al profesional, institución o persona relacionada
            Control1..?
            42. MedicationDispense.performer.actor.display
            Definition

            Nombre del profesional, institución o persona relacionada asociado con el despacho.

            ShortNombre del profesional, institución o persona relacionada
            Control1..?
            44. MedicationDispense.authorizingPrescription
            Definition

            Referencia al recurso de la prescripción (MedicationRequest) que autoriza este despacho.

            ShortReferencia a la prescripción
            Control1..1
            Must Supporttrue
            46. MedicationDispense.authorizingPrescription.reference
            Definition

            Referencia al recurso MedicationRequest relacionado con este despacho.

            ShortReferencia a la prescripción
            Control1..?
            48. MedicationDispense.authorizingPrescription.display
            Definition

            Resumen o nombre descriptivo de la prescripción asociada al despacho.

            ShortResumen de la prescripción
            50. MedicationDispense.quantity
            Definition

            Cantidad total del medicamento que fue entregado al paciente en esta dispensación.

            ShortCantidad despachada
            Control1..?
            Must Supporttrue
            52. MedicationDispense.quantity.value
            Definition

            Número que representa la cantidad del medicamento despachado

            ShortValor numérico de la cantidad
            Control1..?
            54. MedicationDispense.quantity.unit
            Definition

            Unidad en la que se expresa la cantidad del medicamento

            ShortUnidad de medida
            Control1..?
            56. MedicationDispense.daysSupply
            Definition

            Número estimado de días para los que alcanza el medicamento al paciente.

            ShortDuración del tratamiento
            Must Supporttrue
            58. MedicationDispense.daysSupply.value
            Definition

            Cantidad de días que cubre el tratamiento con la dosis.

            ShortNúmero de días
            Control1..?
            60. MedicationDispense.daysSupply.unit
            Definition

            Unidad de medida de tiempo utilizada

            ShortUnidad de tiempo
            Control1..?
            62. MedicationDispense.whenHandedOver
            Definition

            Fecha en la que se entregó el medicamento al paciente durante esta dispensación.

            ShortFecha de entrega
            Control1..?
            64. MedicationDispense.dosageInstruction
            Definition

            Instrucciones detalladas sobre cómo debe administrarse el medicamento entregado al paciente

            ShortInstrucciones de administración entregadas
            Control1..1
            Must Supporttrue
            66. MedicationDispense.dosageInstruction.text
            Definition

            Texto en lenguaje natural que describe cómo debe administrarse el medicamento según lo entregado

            ShortDescripción libre de las instrucciones entregadas
            68. MedicationDispense.dosageInstruction.timing
            Definition

            Define con qué frecuencia y en qué momento del día debe administrarse el medicamento entregado

            ShortFrecuencia y momento de administración entregada
            Control1..?
            70. MedicationDispense.dosageInstruction.timing.repeat
            Definition

            Especificación del intervalo de administración del medicamento tal como fue indicado en el despacho

            ShortPatrón de administración indicado
            Control1..?
            72. MedicationDispense.dosageInstruction.timing.repeat.duration
            Definition

            Tiempo estimado de duración de cada administración del medicamento entregado

            ShortDuración de cada toma
            Control1..?
            74. MedicationDispense.dosageInstruction.timing.repeat.durationUnit
            Definition

            Unidad de medida para la duración de cada toma del medicamento entregado

            ShortUnidad de duración
            Control1..?
            76. MedicationDispense.dosageInstruction.timing.repeat.frequency
            Definition

            Número de veces que se espera que el medicamento entregado sea administrado en un período

            ShortFrecuencia de administración
            Control1..?
            78. MedicationDispense.dosageInstruction.timing.repeat.period
            Definition

            Intervalo de tiempo entre cada administración del medicamento entregado

            ShortPeríodo entre tomas
            80. MedicationDispense.dosageInstruction.timing.repeat.periodUnit
            Definition

            Unidad de tiempo que define el intervalo entre tomas del medicamento entregado

            ShortUnidad de período
            Fixed Valued
            82. MedicationDispense.dosageInstruction.route
            Definition

            Ruta por la cual debe administrarse el medicamento que fue entregado al paciente

            ShortVía de administración
            Control1..?
            BindingThe codes SHALL be taken from Listado de vías de administración
            (required to https://ministeriodesalud.go.cr/fhir/receta/ValueSet/MedicationAdministrationLine)

            Códigos estándar que representan la vía de administración del medicamento entregado

            84. MedicationDispense.dosageInstruction.route.coding
            Definition

            Código estándar que representa la vía por la cual se debe administrar el medicamento entregado

            ShortCodificación de la vía de administración
            Control1..1
            86. MedicationDispense.dosageInstruction.route.coding.system
            Definition

            Sistema que define los códigos para la vía de administración (ej. SNOMED CT)

            ShortSistema de codificación
            88. MedicationDispense.dosageInstruction.route.coding.code
            Definition

            Código que representa una vía de administración específica para el medicamento entregado

            ShortCódigo de la vía
            Control1..?
            90. MedicationDispense.dosageInstruction.route.coding.display
            Definition

            Nombre o descripción legible de la vía de administración del medicamento entregado

            ShortDescripción de la vía
            92. MedicationDispense.dosageInstruction.route.text
            Definition

            Representación textual de la vía de administración del medicamento entregado

            ShortTexto de la vía
            94. MedicationDispense.dosageInstruction.doseAndRate
            Definition

            Información sobre la dosis que debe administrarse del medicamento entregado y la velocidad si aplica

            ShortDosis y velocidad administradas
            Control1..1
            96. MedicationDispense.dosageInstruction.doseAndRate.dose[x]
            Control1..?
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 98. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity
              Slice NamedoseQuantity
              Definition

              Cantidad específica de medicamento entregado que debe administrarse en cada toma

              ShortCantidad por toma
              Control1..1
              TypeQuantity(SimpleQuantity)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              100. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
              Definition

              Cantidad numérica de medicamento que fue entregado por toma

              ShortValor numérico de la dosis
              Control1..?
              102. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit
              Definition

              Unidad de medida en la que se expresa la dosis del medicamento entregado (ej. comprimido(s), cápsula(s))

              ShortUnidad de dosis
              Control1..?

              Guidance on how to interpret the contents of this table can be foundhere

              0. MedicationDispense
              Definition

              Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

              ShortDispensing a medication to a named patient
              Control0..*
              Is Modifierfalse
              Summaryfalse
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
              2. MedicationDispense.id
              Definition

              Identificador único del Despacho dentro del sistema.

              ShortIdentificador único del Despacho dentro del sistema.
              Comments

              Este es el identificador único del Despacho dentro del sistema. Se espera que el Despacho tenga un identificador único dentro del sistema.

              Control0..1
              Typeid
              Is Modifierfalse
              Summarytrue
              4. MedicationDispense.meta
              Definition

              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

              ShortMetadata about the resource
              Control0..0
              TypeMeta
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              6. MedicationDispense.implicitRules
              Definition

              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

              ShortA set of rules under which this content was created
              Comments

              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

              Control0..1
              Typeuri
              Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              8. MedicationDispense.language
              Definition

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

              Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

              Control0..1
              BindingThe codes SHOULD be taken from CommonLanguages
              (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

              A human language.

              Additional BindingsPurpose
              AllLanguagesMax Binding
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              10. MedicationDispense.text
              Definition

              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

              ShortText summary of the resource, for human interpretation
              Comments

              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

              Control0..1
              TypeNarrative
              Is Modifierfalse
              Summaryfalse
              Alternate Namesnarrative, html, xhtml, display
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              12. MedicationDispense.contained
              Definition

              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

              ShortContained, inline Resources
              Comments

              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

              Control0..*
              TypeResource
              Is Modifierfalse
              Summaryfalse
              Alternate Namesinline resources, anonymous resources, contained resources
              14. MedicationDispense.extension
              Definition

              Extensión utilizada para registrar los lotes del medicamento entregado. Puede haber múltiples extensiones si se usaron varios lotes en el despacho.

              ShortLote de medicamento entregado
              Control0..*
              TypeExtension
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              16. MedicationDispense.extension.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              18. MedicationDispense.extension.extension
              Definition

              Contiene dos subextensiones: una para el número de lote y otra para la cantidad entregada de ese lote.

              ShortNúmero y cantidad del lote
              Control2..2
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on MedicationDispense.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 20. MedicationDispense.extension.extension.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                22. MedicationDispense.extension.extension.extension
                Definition

                An Extension

                ShortExtension
                Control0..0
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on MedicationDispense.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 24. MedicationDispense.extension.extension.url
                  Definition

                  Indica si la subextensión corresponde al número de lote o a la cantidad entregada del lote.

                  ShortTipo de valor registrado
                  Comments

                  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.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  26. MedicationDispense.extension.extension.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Control0..1
                  TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on MedicationDispense.extension.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 28. MedicationDispense.extension.extension.value[x]:valueString
                    Slice NamevalueString
                    Definition

                    Código o identificador del lote del medicamento entregado.

                    ShortNúmero de lote
                    Control0..1
                    Typestring
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    30. MedicationDispense.extension.extension.value[x]:valueInteger
                    Slice NamevalueInteger
                    Definition

                    Cantidad del medicamento entregado correspondiente al lote identificado.

                    ShortCantidad del lote
                    Control0..1
                    Typeinteger
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    32. MedicationDispense.extension.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    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.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    34. MedicationDispense.extension.value[x]
                    Definition

                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                    ShortValue of extension
                    Control0..0
                    TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    36. MedicationDispense.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                    Summaryfalse
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    38. MedicationDispense.identifier
                    Definition

                    Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                    ShortExternal identifier
                    Comments

                    This is a business identifier, not a resource identifier.

                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    TypeIdentifier
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    40. MedicationDispense.partOf
                    Definition

                    The procedure that trigger the dispense.

                    ShortEvent that dispense is part of
                    Control0..*
                    TypeReference(Procedure)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    42. MedicationDispense.status
                    Definition

                    Determina el estado del despacho conforme a los códigos definidos por el estándar

                    ShortEntregada | Entregada Parcial | Rechazada
                    Comments

                    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                    Control1..1
                    BindingThe codes SHALL be taken from MedicationDispense Status Codes
                    (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

                    Códigos requeridos por FHIR

                    Typecode
                    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    44. MedicationDispense.statusReason[x]
                    Definition

                    Indicates the reason why a dispense was not performed.

                    ShortWhy a dispense was not performed
                    Control0..1
                    BindingFor example codes, see MedicationDispense Status Reason Codes
                    (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1)

                    A code describing why a dispense was not performed.

                    TypeChoice of: CodeableConcept, Reference(DetectedIssue)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    46. MedicationDispense.category
                    Definition

                    Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

                    ShortType of medication dispense
                    Comments

                    The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.

                    Control0..1
                    BindingThe codes SHOULD be taken from MedicationDispense Category Codes
                    (preferred to http://hl7.org/fhir/ValueSet/medicationdispense-category|4.0.1)

                    A code describing where the dispensed medication is expected to be consumed or administered.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    48. MedicationDispense.medication[x]
                    Definition

                    La referencia al medicamento que está asociado con el despacho.

                    ShortReferencia al medicamento despachado
                    Comments

                    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

                    Control1..1
                    TypeReference(Medication)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    50. MedicationDispense.medication[x].id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    52. MedicationDispense.medication[x].extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on MedicationDispense.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 54. MedicationDispense.medication[x].reference
                      Definition

                      Referencia al recurso del medicamento asociado con el despacho.

                      ShortReferencia al medicamento
                      Comments

                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                      Control1..1
                      This element is affected by the following invariants: ref-1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      56. MedicationDispense.medication[x].type
                      Definition

                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                      ShortType the reference refers to (e.g. "Patient")
                      Comments

                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                      Control0..1
                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                      (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                      Aa resource (or, for logical models, the URI of the logical model).

                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      58. MedicationDispense.medication[x].identifier
                      Definition

                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                      ShortLogical reference, when literal reference is not known
                      Comments

                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      TypeIdentifier
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      60. MedicationDispense.medication[x].display
                      Definition

                      Nombre del medicamento asociado con el despacho.

                      ShortNombre del medicamento
                      Comments

                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      62. MedicationDispense.subject
                      Definition

                      La referencia al paciente que está asociado con el despacho.

                      ShortReferencia al paciente asociado
                      Comments

                      SubstanceAdministration->subject->Patient.

                      Control1..1
                      TypeReference(Patient)
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      64. MedicationDispense.subject.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      66. MedicationDispense.subject.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on MedicationDispense.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 68. MedicationDispense.subject.reference
                        Definition

                        Referencia al recurso del paciente asociado con el despacho.

                        ShortReferencia al paciente
                        Comments

                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                        Control1..1
                        This element is affected by the following invariants: ref-1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        70. MedicationDispense.subject.type
                        Definition

                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                        ShortType the reference refers to (e.g. "Patient")
                        Comments

                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                        (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                        Aa resource (or, for logical models, the URI of the logical model).

                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        72. MedicationDispense.subject.identifier
                        Definition

                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                        ShortLogical reference, when literal reference is not known
                        Comments

                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..1
                        TypeIdentifier
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        74. MedicationDispense.subject.display
                        Definition

                        Nombre del paciente asociado con el despacho.

                        ShortNombre del paciente
                        Comments

                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        76. MedicationDispense.context
                        Definition

                        The encounter or episode of care that establishes the context for this event.

                        ShortEncounter / Episode associated with event
                        Control0..1
                        TypeReference(Encounter, EpisodeOfCare)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        78. MedicationDispense.supportingInformation
                        Definition

                        Additional information that supports the medication being dispensed.

                        ShortInformation that supports the dispensing of the medication
                        Control0..*
                        TypeReference(Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        80. MedicationDispense.performer
                        Definition

                        La referencia al profesional, institución o persona relacionada que se realizó el despacho.

                        ShortReferencia al profesional, institución o persona relacionada asociado
                        Control3..3
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        82. MedicationDispense.performer.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        84. MedicationDispense.performer.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        86. MedicationDispense.performer.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content, modifiers
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        88. MedicationDispense.performer.function
                        Definition

                        Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

                        ShortWho performed the dispense and what they did
                        Control0..1
                        BindingFor example codes, see MedicationDispense Performer Function Codes
                        (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function|4.0.1)

                        A code describing the role an individual played in dispensing a medication.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

                        Allows disambiguation of the types of involvement of different performers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        90. MedicationDispense.performer.actor
                        Definition

                        La referencia al profesional, institución o persona relacionada que está asociado con el despacho.

                        ShortReferencia al profesional, institución o persona relacionada asociado
                        Control1..1
                        TypeReference(Practitioner, Organization, RelatedPerson)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        92. MedicationDispense.performer.actor.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        94. MedicationDispense.performer.actor.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on MedicationDispense.performer.actor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 96. MedicationDispense.performer.actor.reference
                          Definition

                          Referencia al recurso del profesional, institución o persona relacionada asociado con el despacho.

                          ShortReferencia al profesional, institución o persona relacionada
                          Comments

                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                          Control1..1
                          This element is affected by the following invariants: ref-1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          98. MedicationDispense.performer.actor.type
                          Definition

                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                          ShortType the reference refers to (e.g. "Patient")
                          Comments

                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                          Aa resource (or, for logical models, the URI of the logical model).

                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          100. MedicationDispense.performer.actor.identifier
                          Definition

                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                          ShortLogical reference, when literal reference is not known
                          Comments

                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          102. MedicationDispense.performer.actor.display
                          Definition

                          Nombre del profesional, institución o persona relacionada asociado con el despacho.

                          ShortNombre del profesional, institución o persona relacionada
                          Comments

                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          104. MedicationDispense.location
                          Definition

                          The principal physical location where the dispense was performed.

                          ShortWhere the dispense occurred
                          Control0..1
                          TypeReference(Location)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          106. MedicationDispense.authorizingPrescription
                          Definition

                          Referencia al recurso de la prescripción (MedicationRequest) que autoriza este despacho.

                          ShortReferencia a la prescripción
                          Comments

                          Maps to basedOn in Event logical model.

                          Control1..1
                          TypeReference(MedicationRequest)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. MedicationDispense.authorizingPrescription.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          110. MedicationDispense.authorizingPrescription.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on MedicationDispense.authorizingPrescription.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 112. MedicationDispense.authorizingPrescription.reference
                            Definition

                            Referencia al recurso MedicationRequest relacionado con este despacho.

                            ShortReferencia a la prescripción
                            Comments

                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                            Control1..1
                            This element is affected by the following invariants: ref-1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            114. MedicationDispense.authorizingPrescription.type
                            Definition

                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                            ShortType the reference refers to (e.g. "Patient")
                            Comments

                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                            (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                            Aa resource (or, for logical models, the URI of the logical model).

                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            116. MedicationDispense.authorizingPrescription.identifier
                            Definition

                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                            ShortLogical reference, when literal reference is not known
                            Comments

                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            118. MedicationDispense.authorizingPrescription.display
                            Definition

                            Resumen o nombre descriptivo de la prescripción asociada al despacho.

                            ShortResumen de la prescripción
                            Comments

                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. MedicationDispense.type
                            Definition

                            Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                            ShortTrial fill, partial fill, emergency fill, etc.
                            Control0..1
                            BindingFor example codes, see ActPharmacySupplyType
                            (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType)

                            Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. MedicationDispense.quantity
                            Definition

                            Cantidad total del medicamento que fue entregado al paciente en esta dispensación.

                            ShortCantidad despachada
                            Control1..1
                            TypeQuantity(SimpleQuantity)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            124. MedicationDispense.quantity.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            126. MedicationDispense.quantity.extension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on MedicationDispense.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 128. MedicationDispense.quantity.value
                              Definition

                              Número que representa la cantidad del medicamento despachado

                              ShortValor numérico de la cantidad
                              Comments

                              The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                              Control1..1
                              Typedecimal
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Precision is handled implicitly in almost all cases of measurement.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              130. MedicationDispense.quantity.comparator
                              Definition

                              Not allowed to be used in this context

                              Short< | <= | >= | > - how to understand the value
                              Control0..0
                              BindingThe codes SHALL be taken from QuantityComparator
                              (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                              How the Quantity should be understood and represented.

                              Typecode
                              Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                              Meaning if MissingIf there is no comparator, then there is no modification of the value
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              132. MedicationDispense.quantity.unit
                              Definition

                              Unidad en la que se expresa la cantidad del medicamento

                              ShortUnidad de medida
                              Control1..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              134. MedicationDispense.quantity.system
                              Definition

                              The identification of the system that provides the coded form of the unit.

                              ShortSystem that defines coded unit form
                              Control0..1
                              This element is affected by the following invariants: qty-3
                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to know the system that defines the coded form of the unit.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              136. MedicationDispense.quantity.code
                              Definition

                              A computer processable form of the unit in some unit representation system.

                              ShortCoded form of the unit
                              Comments

                              The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                              Control0..1
                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              138. MedicationDispense.daysSupply
                              Definition

                              Número estimado de días para los que alcanza el medicamento al paciente.

                              ShortDuración del tratamiento
                              Control0..1
                              TypeQuantity(SimpleQuantity)
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              140. MedicationDispense.daysSupply.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              142. MedicationDispense.daysSupply.extension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on MedicationDispense.daysSupply.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 144. MedicationDispense.daysSupply.value
                                Definition

                                Cantidad de días que cubre el tratamiento con la dosis.

                                ShortNúmero de días
                                Comments

                                The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                Control1..1
                                Typedecimal
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Precision is handled implicitly in almost all cases of measurement.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                146. MedicationDispense.daysSupply.comparator
                                Definition

                                Not allowed to be used in this context

                                Short< | <= | >= | > - how to understand the value
                                Control0..0
                                BindingThe codes SHALL be taken from QuantityComparator
                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                How the Quantity should be understood and represented.

                                Typecode
                                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                148. MedicationDispense.daysSupply.unit
                                Definition

                                Unidad de medida de tiempo utilizada

                                ShortUnidad de tiempo
                                Control1..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                150. MedicationDispense.daysSupply.system
                                Definition

                                The identification of the system that provides the coded form of the unit.

                                ShortSystem that defines coded unit form
                                Control0..1
                                This element is affected by the following invariants: qty-3
                                Typeuri
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need to know the system that defines the coded form of the unit.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                152. MedicationDispense.daysSupply.code
                                Definition

                                A computer processable form of the unit in some unit representation system.

                                ShortCoded form of the unit
                                Comments

                                The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                Control0..1
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                154. MedicationDispense.whenPrepared
                                Definition

                                The time when the dispensed product was packaged and reviewed.

                                ShortWhen product was packaged and reviewed
                                Control0..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                156. MedicationDispense.whenHandedOver
                                Definition

                                Fecha en la que se entregó el medicamento al paciente durante esta dispensación.

                                ShortFecha de entrega
                                Control1..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                158. MedicationDispense.destination
                                Definition

                                Identification of the facility/location where the medication was shipped to, as part of the dispense event.

                                ShortWhere the medication was sent
                                Control0..1
                                TypeReference(Location)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                160. MedicationDispense.receiver
                                Definition

                                Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

                                ShortWho collected the medication
                                Control0..*
                                TypeReference(Patient, Practitioner)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                162. MedicationDispense.note
                                Definition

                                Extra information about the dispense that could not be conveyed in the other attributes.

                                ShortInformation about the dispense
                                Control0..*
                                TypeAnnotation
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                164. MedicationDispense.dosageInstruction
                                Definition

                                Instrucciones detalladas sobre cómo debe administrarse el medicamento entregado al paciente

                                ShortInstrucciones de administración entregadas
                                Comments

                                When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

                                Control1..1
                                TypeDosage
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                166. MedicationDispense.dosageInstruction.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                168. MedicationDispense.dosageInstruction.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 170. MedicationDispense.dosageInstruction.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  172. MedicationDispense.dosageInstruction.sequence
                                  Definition

                                  Indicates the order in which the dosage instructions should be applied or interpreted.

                                  ShortThe order of the dosage instructions
                                  Control0..1
                                  Typeinteger
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  174. MedicationDispense.dosageInstruction.text
                                  Definition

                                  Texto en lenguaje natural que describe cómo debe administrarse el medicamento según lo entregado

                                  ShortDescripción libre de las instrucciones entregadas
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  176. MedicationDispense.dosageInstruction.additionalInstruction
                                  Definition

                                  Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

                                  ShortSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
                                  Comments

                                  Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

                                  Control0..*
                                  BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                  (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes|4.0.1)

                                  A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  178. MedicationDispense.dosageInstruction.patientInstruction
                                  Definition

                                  Instructions in terms that are understood by the patient or consumer.

                                  ShortPatient or consumer oriented instructions
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  180. MedicationDispense.dosageInstruction.timing
                                  Definition

                                  Define con qué frecuencia y en qué momento del día debe administrarse el medicamento entregado

                                  ShortFrecuencia y momento de administración entregada
                                  Comments

                                  This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

                                  Control1..1
                                  TypeTiming
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  182. MedicationDispense.dosageInstruction.timing.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  184. MedicationDispense.dosageInstruction.timing.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.timing.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 186. MedicationDispense.dosageInstruction.timing.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                    Summarytrue
                                    Requirements

                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                    Alternate Namesextensions, user content, modifiers
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    188. MedicationDispense.dosageInstruction.timing.event
                                    Definition

                                    Identifies specific times when the event occurs.

                                    ShortWhen the event occurs
                                    Control0..*
                                    TypedateTime
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    190. MedicationDispense.dosageInstruction.timing.repeat
                                    Definition

                                    Especificación del intervalo de administración del medicamento tal como fue indicado en el despacho

                                    ShortPatrón de administración indicado
                                    Control1..1
                                    TypeElement
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Many timing schedules are determined by regular repetitions.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    tim-1: if there's a duration, there needs to be duration units (duration.empty() or durationUnit.exists())
                                    tim-2: if there's a period, there needs to be period units (period.empty() or periodUnit.exists())
                                    tim-4: duration SHALL be a non-negative value (duration.exists() implies duration >= 0)
                                    tim-5: period SHALL be a non-negative value (period.exists() implies period >= 0)
                                    tim-6: If there's a periodMax, there must be a period (periodMax.empty() or period.exists())
                                    tim-7: If there's a durationMax, there must be a duration (durationMax.empty() or duration.exists())
                                    tim-8: If there's a countMax, there must be a count (countMax.empty() or count.exists())
                                    tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
                                    tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (timeOfDay.empty() or when.empty())
                                    192. MedicationDispense.dosageInstruction.timing.repeat.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    194. MedicationDispense.dosageInstruction.timing.repeat.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.timing.repeat.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 196. MedicationDispense.dosageInstruction.timing.repeat.bounds[x]
                                      Definition

                                      Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

                                      ShortLength/Range of lengths, or (Start and/or end) limits
                                      Control0..1
                                      TypeChoice of: Duration, Range, Period
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      198. MedicationDispense.dosageInstruction.timing.repeat.count
                                      Definition

                                      A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

                                      ShortNumber of times to repeat
                                      Comments

                                      If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

                                      Control0..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Repetitions may be limited by end time or total occurrences.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      200. MedicationDispense.dosageInstruction.timing.repeat.countMax
                                      Definition

                                      If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

                                      ShortMaximum number of times to repeat
                                      Control0..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      202. MedicationDispense.dosageInstruction.timing.repeat.duration
                                      Definition

                                      Tiempo estimado de duración de cada administración del medicamento entregado

                                      ShortDuración de cada toma
                                      Comments

                                      For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                      Control1..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Some activities are not instantaneous and need to be maintained for a period of time.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      204. MedicationDispense.dosageInstruction.timing.repeat.durationMax
                                      Definition

                                      If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

                                      ShortHow long when it happens (Max)
                                      Comments

                                      For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

                                      Control0..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Some activities are not instantaneous and need to be maintained for a period of time.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      206. MedicationDispense.dosageInstruction.timing.repeat.durationUnit
                                      Definition

                                      Unidad de medida para la duración de cada toma del medicamento entregado

                                      ShortUnidad de duración
                                      Control1..1
                                      BindingThe codes SHALL be taken from UnitsOfTime
                                      (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                      A unit of time (units from UCUM).

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      208. MedicationDispense.dosageInstruction.timing.repeat.frequency
                                      Definition

                                      Número de veces que se espera que el medicamento entregado sea administrado en un período

                                      ShortFrecuencia de administración
                                      Control1..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      210. MedicationDispense.dosageInstruction.timing.repeat.frequencyMax
                                      Definition

                                      If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

                                      ShortEvent occurs up to frequencyMax times per period
                                      Control0..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      212. MedicationDispense.dosageInstruction.timing.repeat.period
                                      Definition

                                      Intervalo de tiempo entre cada administración del medicamento entregado

                                      ShortPeríodo entre tomas
                                      Control0..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      214. MedicationDispense.dosageInstruction.timing.repeat.periodMax
                                      Definition

                                      If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

                                      ShortUpper limit of period (3-4 hours)
                                      Control0..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      216. MedicationDispense.dosageInstruction.timing.repeat.periodUnit
                                      Definition

                                      Unidad de tiempo que define el intervalo entre tomas del medicamento entregado

                                      ShortUnidad de período
                                      Control0..1
                                      BindingThe codes SHALL be taken from UnitsOfTime
                                      (required to http://hl7.org/fhir/ValueSet/units-of-time|4.0.1)

                                      A unit of time (units from UCUM).

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Fixed Valued
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      218. MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek
                                      Definition

                                      If one or more days of week is provided, then the action happens only on the specified day(s).

                                      Shortmon | tue | wed | thu | fri | sat | sun
                                      Comments

                                      If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

                                      Control0..*
                                      BindingThe codes SHALL be taken from DaysOfWeek
                                      (required to http://hl7.org/fhir/ValueSet/days-of-week|4.0.1)
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      220. MedicationDispense.dosageInstruction.timing.repeat.timeOfDay
                                      Definition

                                      Specified time of day for action to take place.

                                      ShortTime of day for action
                                      Comments

                                      When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

                                      Control0..*
                                      Typetime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      222. MedicationDispense.dosageInstruction.timing.repeat.when
                                      Definition

                                      An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

                                      ShortCode for time period of occurrence
                                      Comments

                                      When more than one event is listed, the event is tied to the union of the specified events.

                                      Control0..*
                                      BindingThe codes SHALL be taken from EventTiming
                                      (required to http://hl7.org/fhir/ValueSet/event-timing|4.0.1)

                                      Real world event relating to the schedule.

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Timings are frequently determined by occurrences such as waking, eating and sleep.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      224. MedicationDispense.dosageInstruction.timing.repeat.offset
                                      Definition

                                      The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

                                      ShortMinutes from event (before or after)
                                      Control0..1
                                      TypeunsignedInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      226. MedicationDispense.dosageInstruction.timing.code
                                      Definition

                                      A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

                                      ShortBID | TID | QID | AM | PM | QD | QOD | +
                                      Comments

                                      BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

                                      Control0..1
                                      BindingThe codes SHOULD be taken from TimingAbbreviation
                                      (preferred to http://hl7.org/fhir/ValueSet/timing-abbreviation|4.0.1)

                                      Code for a known / defined timing pattern.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      228. MedicationDispense.dosageInstruction.asNeeded[x]
                                      Definition

                                      Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

                                      ShortTake "as needed" (for x)
                                      Comments

                                      Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

                                      Control0..1
                                      BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                      (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason|4.0.1)

                                      A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

                                      TypeChoice of: boolean, CodeableConcept
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      230. MedicationDispense.dosageInstruction.site
                                      Definition

                                      Body site to administer to.

                                      ShortBody site to administer to
                                      Comments

                                      If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                                      Control0..1
                                      BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                      (example to http://hl7.org/fhir/ValueSet/approach-site-codes|4.0.1)

                                      A coded concept describing the site location the medicine enters into or onto the body.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A coded specification of the anatomic site where the medication first enters the body.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      232. MedicationDispense.dosageInstruction.route
                                      Definition

                                      Ruta por la cual debe administrarse el medicamento que fue entregado al paciente

                                      ShortVía de administración
                                      Control1..1
                                      BindingThe codes SHALL be taken from Listado de vías de administración
                                      (required to https://ministeriodesalud.go.cr/fhir/receta/ValueSet/MedicationAdministrationLine)

                                      Códigos estándar que representan la vía de administración del medicamento entregado

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      234. MedicationDispense.dosageInstruction.route.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      236. MedicationDispense.dosageInstruction.route.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.route.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 238. MedicationDispense.dosageInstruction.route.coding
                                        Definition

                                        Código estándar que representa la vía por la cual se debe administrar el medicamento entregado

                                        ShortCodificación de la vía de administración
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control1..1
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        240. MedicationDispense.dosageInstruction.route.coding.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        242. MedicationDispense.dosageInstruction.route.coding.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.route.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 244. MedicationDispense.dosageInstruction.route.coding.system
                                          Definition

                                          Sistema que define los códigos para la vía de administración (ej. SNOMED CT)

                                          ShortSistema de codificación
                                          Comments

                                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                          Control0..1
                                          Typeuri
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Need to be unambiguous about the source of the definition of the symbol.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          246. MedicationDispense.dosageInstruction.route.coding.version
                                          Definition

                                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                          ShortVersion of the system - if relevant
                                          Comments

                                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          248. MedicationDispense.dosageInstruction.route.coding.code
                                          Definition

                                          Código que representa una vía de administración específica para el medicamento entregado

                                          ShortCódigo de la vía
                                          Control1..1
                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Need to refer to a particular code in the system.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          250. MedicationDispense.dosageInstruction.route.coding.display
                                          Definition

                                          Nombre o descripción legible de la vía de administración del medicamento entregado

                                          ShortDescripción de la vía
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          252. MedicationDispense.dosageInstruction.route.coding.userSelected
                                          Definition

                                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                          ShortIf this coding was chosen directly by the user
                                          Comments

                                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                          Control0..1
                                          Typeboolean
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          254. MedicationDispense.dosageInstruction.route.text
                                          Definition

                                          Representación textual de la vía de administración del medicamento entregado

                                          ShortTexto de la vía
                                          Comments

                                          Very often the text is the same as a displayName of one of the codings.

                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          256. MedicationDispense.dosageInstruction.method
                                          Definition

                                          Technique for administering medication.

                                          ShortTechnique for administering medication
                                          Comments

                                          Terminologies used often pre-coordinate this term with the route and or form of administration.

                                          Control0..1
                                          BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                          (example to http://hl7.org/fhir/ValueSet/administration-method-codes|4.0.1)

                                          A coded concept describing the technique by which the medicine is administered.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          258. MedicationDispense.dosageInstruction.doseAndRate
                                          Definition

                                          Información sobre la dosis que debe administrarse del medicamento entregado y la velocidad si aplica

                                          ShortDosis y velocidad administradas
                                          Control1..1
                                          TypeElement
                                          Is Modifierfalse
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          260. MedicationDispense.dosageInstruction.doseAndRate.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          262. MedicationDispense.dosageInstruction.doseAndRate.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 264. MedicationDispense.dosageInstruction.doseAndRate.type
                                            Definition

                                            The kind of dose or rate specified, for example, ordered or calculated.

                                            ShortThe kind of dose or rate specified
                                            Control0..1
                                            BindingFor example codes, see DoseAndRateType
                                            (example to http://hl7.org/fhir/ValueSet/dose-rate-type|4.0.1)

                                            The kind of dose or rate specified.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            If the type is not populated, assume to be "ordered".

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            266. MedicationDispense.dosageInstruction.doseAndRate.dose[x]
                                            Definition

                                            Amount of medication per dose.

                                            ShortAmount of medication per dose
                                            Comments

                                            Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                            Control1..1
                                            TypeQuantity(SimpleQuantity)
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            The amount of therapeutic or other substance given at one administration event.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.doseAndRate.dose[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                            • type @ $this
                                            • 268. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity
                                              Slice NamedoseQuantity
                                              Definition

                                              Cantidad específica de medicamento entregado que debe administrarse en cada toma

                                              ShortCantidad por toma
                                              Comments

                                              Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

                                              Control1..1
                                              TypeQuantity(SimpleQuantity)
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              The amount of therapeutic or other substance given at one administration event.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              270. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              272. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on MedicationDispense.dosageInstruction.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 274. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
                                                Definition

                                                Cantidad numérica de medicamento que fue entregado por toma

                                                ShortValor numérico de la dosis
                                                Comments

                                                The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                Control1..1
                                                Typedecimal
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Precision is handled implicitly in almost all cases of measurement.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                276. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator
                                                Definition

                                                Not allowed to be used in this context

                                                Short< | <= | >= | > - how to understand the value
                                                Control0..0
                                                BindingThe codes SHALL be taken from QuantityComparator
                                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                How the Quantity should be understood and represented.

                                                Typecode
                                                Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                278. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit
                                                Definition

                                                Unidad de medida en la que se expresa la dosis del medicamento entregado (ej. comprimido(s), cápsula(s))

                                                ShortUnidad de dosis
                                                Control1..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                280. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system
                                                Definition

                                                The identification of the system that provides the coded form of the unit.

                                                ShortSystem that defines coded unit form
                                                Control0..1
                                                This element is affected by the following invariants: qty-3
                                                Typeuri
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need to know the system that defines the coded form of the unit.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                282. MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code
                                                Definition

                                                A computer processable form of the unit in some unit representation system.

                                                ShortCoded form of the unit
                                                Comments

                                                The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                Control0..1
                                                Typecode
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                284. MedicationDispense.dosageInstruction.doseAndRate.rate[x]
                                                Definition

                                                Amount of medication per unit of time.

                                                ShortAmount of medication per unit of time
                                                Comments

                                                It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

                                                It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

                                                Control0..1
                                                TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                286. MedicationDispense.dosageInstruction.maxDosePerPeriod
                                                Definition

                                                Upper limit on medication per unit of time.

                                                ShortUpper limit on medication per unit of time
                                                Comments

                                                This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

                                                Control0..1
                                                TypeRatio
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                288. MedicationDispense.dosageInstruction.maxDosePerAdministration
                                                Definition

                                                Upper limit on medication per administration.

                                                ShortUpper limit on medication per administration
                                                Comments

                                                This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

                                                Control0..1
                                                TypeQuantity(SimpleQuantity)
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                290. MedicationDispense.dosageInstruction.maxDosePerLifetime
                                                Definition

                                                Upper limit on medication per lifetime of the patient.

                                                ShortUpper limit on medication per lifetime of the patient
                                                Control0..1
                                                TypeQuantity(SimpleQuantity)
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                292. MedicationDispense.substitution
                                                Definition

                                                Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.

                                                ShortWhether a substitution was performed on the dispense
                                                Control0..1
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                294. MedicationDispense.substitution.id
                                                Definition

                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                296. MedicationDispense.substitution.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                298. MedicationDispense.substitution.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                300. MedicationDispense.substitution.wasSubstituted
                                                Definition

                                                True if the dispenser dispensed a different drug or product from what was prescribed.

                                                ShortWhether a substitution was or was not performed on the dispense
                                                Control1..1
                                                Typeboolean
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                302. MedicationDispense.substitution.type
                                                Definition

                                                A code signifying whether a different drug was dispensed from what was prescribed.

                                                ShortCode signifying whether a different drug was dispensed from what was prescribed
                                                Control0..1
                                                BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                                (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                                A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                304. MedicationDispense.substitution.reason
                                                Definition

                                                Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

                                                ShortWhy was substitution made
                                                Control0..*
                                                BindingFor example codes, see SubstanceAdminSubstitutionReason
                                                (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                                                A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                306. MedicationDispense.substitution.responsibleParty
                                                Definition

                                                The person or organization that has primary responsibility for the substitution.

                                                ShortWho is responsible for the substitution
                                                Control0..*
                                                TypeReference(Practitioner, PractitionerRole)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                308. MedicationDispense.detectedIssue
                                                Definition

                                                Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

                                                ShortClinical issue with action
                                                Comments

                                                This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                                                Control0..*
                                                TypeReference(DetectedIssue)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                310. MedicationDispense.eventHistory
                                                Definition

                                                A summary of the events of interest that have occurred, such as when the dispense was verified.

                                                ShortA list of relevant lifecycle events
                                                Comments

                                                This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                                                Control0..*
                                                TypeReference(Provenance)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))