---
type: "resource-definitions"
title: "MedicationDispense Definitions"
resource: "MedicationDispense"
---

# MedicationDispense Definitions

<a id="MedicationDispense"></a>

## MedicationDispense
Dispensing a medication to a named patient

**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.

**Cardinality:** 0..*

**Constraints:** mdd-1 | error | whenHandedOver cannot be before whenPrepared | (whenHandedOver.hasValue() and whenPrepared.hasValue()) implies whenHandedOver >= whenPrepared

**Mappings:** workflow=Event; rim=Supply[moodCode=EVN]; w5=clinical.medication


<a id="MedicationDispense.identifier"></a>

## MedicationDispense.identifier
External 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.

**Comments:** This is a business identifier, not a resource identifier.

**Cardinality:** 0..*

**Type:** [Identifier](/Identifier)

**Mappings:** workflow=Event.identifier; w5=FiveWs.identifier; rim=.id; rx-dispense-rmim=CombinedMedicationDispense.id


<a id="MedicationDispense.basedOn"></a>

## MedicationDispense.basedOn
Plan that is fulfilled by this dispense

**Definition:** A plan that is fulfilled in whole or in part by this MedicationDispense.

**Cardinality:** 0..*

**Type:** Reference([CarePlan](/CarePlan))

**Mappings:** rim=.outboundRelationship[typeCode=FLFS].target


<a id="MedicationDispense.partOf"></a>

## MedicationDispense.partOf
Event that dispense is part of

**Definition:** The procedure or medication administration that triggered the dispense.

**Comments:** While both a procedure and a medication administration may have triggered the dispense, but it is not expected that multiple procedures and/or multiple medication administrations would be triggers.

**Cardinality:** 0..*

**Type:** Reference([Procedure](/Procedure), [MedicationAdministration](/MedicationAdministration))

**Mappings:** workflow=Event.partOf; rim=.outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]


<a id="MedicationDispense.status"></a>

## MedicationDispense.status
preparation | in-progress | cancelled | on-hold | completed | entered-in-error | unfulfilled | declined | unknown

**Definition:** A code specifying the state of the set of dispense events.

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

**Cardinality:** 1..1

**Type:** [code](/code)

**Binding:** required:[medicationdispense-status](/valueset-medicationdispense-status)

**Summary:** true

**Is Modifier:** true (Reason: 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)

**Mappings:** workflow=Event.status; w5=FiveWs.status; rim=.statusCode; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.statusCode


<a id="MedicationDispense.notPerformedReason"></a>

## MedicationDispense.notPerformedReason
Why a dispense was not performed

**Definition:** Indicates the reason why a dispense was not performed.

**Cardinality:** 0..1

**Type:** [CodeableReference](/CodeableReference)

**Binding:** example:[medicationdispense-status-reason](/valueset-medicationdispense-status-reason)


<a id="MedicationDispense.statusChanged"></a>

## MedicationDispense.statusChanged
When the status changed

**Definition:** The date (and maybe time) when the status of the dispense record changed.

**Cardinality:** 0..1

**Type:** [dateTime](/dateTime)

**Mappings:** rim=.subjectOf Observation[code = statusChange].value = date


<a id="MedicationDispense.category"></a>

## MedicationDispense.category
Type of medication dispense

**Definition:** Indicates the type of medication dispense (for example, drug classification like ATC, where meds would be administered, legal category of the medication.).

**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.  

The committee will revisit these codes, expecting to use a codesystem from [terminology.hl7.org](http://terminology.hl7.org).

**Cardinality:** 0..*

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[medicationdispense-category](/valueset-medicationdispense-category)

**Mappings:** rim=.inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value


<a id="MedicationDispense.medication"></a>

## MedicationDispense.medication
What medication was (or was intended to be) supplied

**Definition:** Identifies the medication supplied (or intended to be supplied). This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

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

**Cardinality:** 1..1

**Type:** [CodeableReference](/CodeableReference)

**Binding:** example:[medication-codes](/valueset-medication-codes)

**Summary:** true

**Mappings:** workflow=Event.code; w5=FiveWs.what[x]; v2=RXD-2 Dispense/Give Code; rim=.participation[typeCode=PRD].role; rx-dispense-rmim=CombinedMedicationRequest.component1.AdministrationRequest.consumable


<a id="MedicationDispense.subject"></a>

## MedicationDispense.subject
Who the dispense is for

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

**Comments:** SubstanceAdministration->subject->Patient.

**Cardinality:** 1..1

**Type:** Reference([Patient](/Patient), [Group](/Group))

**Summary:** true

**Mappings:** workflow=Event.subject; w5=FiveWs.subject; v2=PID-3 Patient ID List; rim=.participation[typeCode=SBJ].role[classCode=PAT]


<a id="MedicationDispense.encounter"></a>

## MedicationDispense.encounter
Encounter associated with event

**Definition:** The encounter that establishes the context for this event.

**Cardinality:** 0..1

**Type:** Reference([Encounter](/Encounter))

**Mappings:** workflow=Event.encounter; rim=.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]


<a id="MedicationDispense.supportingInformation"></a>

## MedicationDispense.supportingInformation
Information that supports the dispensing of the medication

**Definition:** Additional information that supports the medication being dispensed.  For example, there may be requirements that a specific lab test has been completed prior to dispensing or the patient's weight at the time of dispensing is documented.

**Cardinality:** 0..*

**Type:** Reference([Resource](/Resource))

**Mappings:** w5=FiveWs.context; rim=.outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]


<a id="MedicationDispense.performer"></a>

## MedicationDispense.performer
Who performed event

**Definition:** Indicates who or what performed the event.

**Cardinality:** 0..*

**Type:** [BackboneElement](/BackboneElement)

**Mappings:** workflow=Event.performer; rim=.participation[typeCode=PRF]


<a id="MedicationDispense.performer.function"></a>

## MedicationDispense.performer.function
Who performed the dispense and what they did

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

**Requirements:** Allows disambiguation of the types of involvement of different performers.

**Cardinality:** 0..1

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[medicationdispense-performer-function](/valueset-medicationdispense-performer-function)

**Mappings:** rim=participation[typeCode=PRF].functionCode


<a id="MedicationDispense.performer.actor"></a>

## MedicationDispense.performer.actor
Individual who was performing

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

**Comments:** The different performer functions within a dispense process can vary - and some of these functions may be restricted to clinical professionals - such distinction is usually specific to a jurisdiction and context. While performer.function and performer.actor don't add restrictions on which resources can be referenced, this element is expected to be used according to the local restrictions, for example not allowing Group (e.g., household) or RelatedPerson to be the dispenser.

**Cardinality:** 1..1

**Type:** Reference([Practitioner](/Practitioner), [PractitionerRole](/PractitionerRole), [Organization](/Organization), [Patient](/Patient), [Device](/Device), [RelatedPerson](/RelatedPerson), [CareTeam](/CareTeam), [Group](/Group))

**Mappings:** workflow=Event.performer.actor; rim=.role


<a id="MedicationDispense.location"></a>

## MedicationDispense.location
Where the dispense occurred

**Definition:** The principal physical location where the dispense was performed.

**Cardinality:** 0..1

**Type:** Reference([Location](/Location))

**Mappings:** rim=.participation[typeCode=LOC].role


<a id="MedicationDispense.authorizingPrescription"></a>

## MedicationDispense.authorizingPrescription
Medication order that authorizes the dispense

**Definition:** Indicates the medication order that is being dispensed against.

**Comments:** Maps to basedOn in Event logical model.

**Cardinality:** 0..*

**Type:** Reference([MedicationRequest](/MedicationRequest))

**Mappings:** workflow=Event.basedOn; v2=ORC-2 Placer Order Number; rim=.outboundRelationship[typeCode=FLFS].target[moodCode=RQO]; rx-dispense-rmim=CombinedMedicationDispense.inFulfillmentOf


<a id="MedicationDispense.type"></a>

## MedicationDispense.type
Trial fill, partial fill, emergency fill, etc

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

**Cardinality:** 0..1

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[v3-ActPharmacySupplyType](/valueset-v3-ActPharmacySupplyType)

**Mappings:** v2=RXD-33 Dispense Type; rim=.code; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.code


<a id="MedicationDispense.quantity"></a>

## MedicationDispense.quantity
Amount of medication

**Definition:** The amount of medication that has been (or was intended to be) dispensed. Includes unit of measure.

**Cardinality:** 0..1

**Type:** [Quantity](/Quantity)([SimpleQuantity](/SimpleQuantity))

**Mappings:** v2=RXD-4 Actual Dispense Amount / RXD-5.1 Actual Dispense Units.code / RXD-5.3 Actual Dispense Units.name of coding system; rim=.quantity; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.quantity


<a id="MedicationDispense.daysSupply"></a>

## MedicationDispense.daysSupply
Amount of medication expressed as a timing amount

**Definition:** The amount of medication expressed as a timing amount.

**Cardinality:** 0..1

**Type:** [Quantity](/Quantity)([SimpleQuantity](/SimpleQuantity))

**Mappings:** v2=TQ1.6 Timing/Quantity Segment Service Duration.
Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component.  This is a formatted string, first character for the time unit (e.g., D=days), followed by the value.  For example, “D14” represents “14 days supply”
From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration.  This is a CQ data type ([Quantity (NM)] ^ [Units (CWE)]), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^
For backwards compatibility, ORC.7 was permitted through v2.6.  Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6; rim=effectiveUseTime


<a id="MedicationDispense.fillNumber"></a>

## MedicationDispense.fillNumber
A number that represents the known fill this dispense represents

**Definition:** Represents the known number of the fill over the entire lifetime of the prescription, i.e. if this is the first dispense by this pharmacy but the third fill overall, then the fillNumber will be 3.  Each fill number represents one dispensation, even if that dispensation is not for the full quantity.  Partial fills are not represented by decimal quantities, i.e., a partial fill of 40 tablets (full quantity is 100 tablets) adds 1 to the prior fill number, not 0.4. This means that the 'fillNumber' may sometimes be higher than the MedicationRequest.numberOfRepeatsAllowed, as the latter assumes full fills, while fillNumber does not.

**Comments:** This element may  be inaccurate as it relies on the dispensing pharmacy to be aware of all fills that have occurred for the request.

**Cardinality:** 0..1

**Type:** [positiveInt](/positiveInt)


<a id="MedicationDispense.recorded"></a>

## MedicationDispense.recorded
When the recording of the dispense started

**Definition:** The date the occurrence of the MedicationDispense was first captured in the system.

**Cardinality:** 0..1

**Type:** [dateTime](/dateTime)

**Mappings:** rim=.MedicationDispense.dataEnterer..time


<a id="MedicationDispense.whenPrepared"></a>

## MedicationDispense.whenPrepared
When product was packaged and reviewed

**Definition:** The time when the dispensed product was packaged and reviewed.

**Conditions:** mdd-1

**Cardinality:** 0..1

**Type:** [dateTime](/dateTime)

**Summary:** true

**Mappings:** v2=RXD-3 Date/Time Dispensed; rim=.effectiveTime[xmi:type=IVL_TS].low; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.effectiveTime


<a id="MedicationDispense.whenHandedOver"></a>

## MedicationDispense.whenHandedOver
When product was given out

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

**Conditions:** mdd-1

**Cardinality:** 0..1

**Type:** [dateTime](/dateTime)

**Mappings:** workflow=Event.occurrence[x]; v2=RXD-3 Date/Time Dispensed; rim=.effectiveTime[xmi:type=IVL_TS].high; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.effectiveTime


<a id="MedicationDispense.destination"></a>

## MedicationDispense.destination
Where the medication was/will be sent

**Definition:** Identification of the facility/location where the medication was/will be shipped to, as part of the dispense event.

**Cardinality:** 0..1

**Type:** Reference([Location](/Location))

**Mappings:** v2=RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address; rim=.participation[typeCode=DST].role; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.destination


<a id="MedicationDispense.receiver"></a>

## MedicationDispense.receiver
Who collected the medication or where the medication was delivered

**Definition:** Identifies the person who picked up the medication or the location or organization where the medication was delivered. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional or a location, or organization.

**Cardinality:** 0..*

**Type:** Reference([Patient](/Patient), [Practitioner](/Practitioner), [RelatedPerson](/RelatedPerson), [Location](/Location), [PractitionerRole](/PractitionerRole), [Organization](/Organization), [Group](/Group))

**Mappings:** rim=.participation[typeCode=RCV].role; rx-dispense-rmim=CombinedMedicationDispense.SupplyEvent.receiver


<a id="MedicationDispense.note"></a>

## MedicationDispense.note
Information about the dispense

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

**Cardinality:** 0..*

**Type:** [Annotation](/Annotation)

**Mappings:** workflow=Event.note; v2=RXD-9 Dispense Notes; rim=.inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]


<a id="MedicationDispense.dosageInstruction"></a>

## MedicationDispense.dosageInstruction
How the medication is to be used by the patient or administered by the caregiver

**Definition:** Indicates how the medication is to be used by the patient.

**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.

**Cardinality:** 0..1

**Type:** [DosageDetails](/DosageDetails)

**Mappings:** rim=.outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]


<a id="MedicationDispense.doseAdministrationAid"></a>

## MedicationDispense.doseAdministrationAid
Type of adherence packaging to use for the dispense

**Definition:** Provides information about the type of adherence packaging supplied for the medication dispense.

**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.

**Cardinality:** 0..1

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[medication-dose-aid](/valueset-medication-dose-aid)


<a id="MedicationDispense.substitution"></a>

## MedicationDispense.substitution
Whether a substitution was performed on the dispense

**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.

**Cardinality:** 0..1

**Type:** [BackboneElement](/BackboneElement)

**Mappings:** rim=.outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]; rx-dispense-rmim=CombinedMedicationDispense.substitutionMade


<a id="MedicationDispense.substitution.wasSubstituted"></a>

## MedicationDispense.substitution.wasSubstituted
Whether a substitution was or was not performed on the dispense

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

**Cardinality:** 1..1

**Type:** [boolean](/boolean)

**Mappings:** rim=.actionNegationInd


<a id="MedicationDispense.substitution.type"></a>

## MedicationDispense.substitution.type
Code signifying whether a different drug was dispensed from what was prescribed

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

**Cardinality:** 0..1

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[v3-ActSubstanceAdminSubstitutionCode](/valueset-v3-ActSubstanceAdminSubstitutionCode)

**Mappings:** v2=RXO-9 Allow Substitutions / RXE-9 Substitution Status; rim=.code; rx-dispense-rmim=CombinedMedicationDispense.substitutionMade.code


<a id="MedicationDispense.substitution.reason"></a>

## MedicationDispense.substitution.reason
Why was substitution made

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

**Cardinality:** 0..*

**Type:** [CodeableConcept](/CodeableConcept)

**Binding:** example:[v3-SubstanceAdminSubstitutionReason](/valueset-v3-SubstanceAdminSubstitutionReason)

**Mappings:** rim=.reasonCode; rx-dispense-rmim=CombinedMedicationDispense.substitutionMade.reasonCode


<a id="MedicationDispense.substitution.responsibleParty"></a>

## MedicationDispense.substitution.responsibleParty
Who is responsible for the substitution

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

**Cardinality:** 0..1

**Type:** Reference([Practitioner](/Practitioner), [PractitionerRole](/PractitionerRole), [Organization](/Organization))

**Mappings:** rim=.participation[typeCode=PFM].role[classCode=ASSIGN]; rx-dispense-rmim=CombinedMedicationDispense.substitutionMade.ResponsibleParty


<a id="MedicationDispense.eventHistory"></a>

## MedicationDispense.eventHistory
A list of relevant lifecycle events

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

**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.).

**Cardinality:** 0..*

**Type:** Reference([Provenance](/Provenance))

**Mappings:** rim=.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]