Amakomaya Nepal FHIR Implementation Guide
1.0.1 - ci-build

Amakomaya Nepal FHIR Implementation Guide - Local Development build (v1.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: AMK Core Medication Dispense Profile

Official URL: https://fhir.amakomaya.com/StructureDefinition/amk-core-medication-dispense | Version: 1.0.1
Active as of 2026-06-15 | Computable Name: AMKCoreMedicationDispenseProfile
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The AMK Core MedicationDispense Profile inherits from the FHIR MedicationDispense resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the MedicationDispense resource to record, search, and fetch information about medications dispensed to a patient within the Nepal health system. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used.

Usages:

- Examples for this Profile: MedicationDispense/medication-dispense-albendazole, MedicationDispense/medication-dispense-calcium and MedicationDispense/medication-dispense-iron

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | Dispensing a medication to a named patient Constraints: mdd-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained |  | 0..* | Resource | Contained, inline Resources
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.
medication | Σ | 1..1 | CodeableReference(Medication) | What medication was supplied Binding: Dietary Supplements (SNOMED) (required)
subject | Σ | 1..1 | Reference(AMK Core Patient Profile) | Who the dispense is for
quantity |  | 1..1 | SimpleQuantity(5.0.0) | Amount dispensed
value | Σ | 1..1 | decimal | Numerical value (with implicit precision)
unit | Σ | 1..1 | string | Unit representation
system | Σ C | 1..1 | uri | System that defines coded unit form
code | Σ C | 1..1 | code | Coded form of the unit
recorded |  | 1..1 | dateTime | When the recording of the dispense started
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.status | Base | required | MedicationDispense Status Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.medication | Base | required | Dietary Supplements (SNOMED) | 📦1.0.1 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationDispense | 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationDispense | 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 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared | `whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared`

This structure is derived from MedicationDispense

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense |  | 0..* | MedicationDispense | Dispensing a medication to a named patient
medication |  | 1..1 | CodeableReference(Medication) | What medication was supplied Binding: Dietary Supplements (SNOMED) (required)
subject |  | 1..1 | Reference(AMK Core Patient Profile) | Who the dispense is for
quantity |  | 1..1 | SimpleQuantity(5.0.0) | Amount dispensed
value |  | 1..1 | decimal | Numerical value (with implicit precision)
unit |  | 1..1 | string | Unit representation
system |  | 1..1 | uri | System that defines coded unit form
code |  | 1..1 | code | Coded form of the unit
recorded |  | 1..1 | dateTime | When the recording of the dispense started
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.medication | Base | required | Dietary Supplements (SNOMED) | 📦1.0.1 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | Dispensing a medication to a named patient Constraints: mdd-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language
Additional Bindings | Purpose
CommonLanguages | Starter
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External identifier
basedOn |  | 0..* | Reference(CarePlan) | Plan that is fulfilled by this dispense
partOf |  | 0..* | Reference(Procedure | MedicationAdministration) | Event that dispense is part of
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.
notPerformedReason |  | 0..1 | CodeableReference(DetectedIssue) | Why a dispense was not performed Binding: MedicationDispenseStatusReasonCodes (example)
statusChanged |  | 0..1 | dateTime | When the status changed
category |  | 0..* | CodeableConcept | Type of medication dispense Binding: MedicationDispenseAdministrationLocationCodes (example): A code describing where the dispensed medication is expected to be consumed or administered.
medication | Σ | 1..1 | CodeableReference(Medication) | What medication was supplied Binding: Dietary Supplements (SNOMED) (required)
subject | Σ | 1..1 | Reference(AMK Core Patient Profile) | Who the dispense is for
encounter |  | 0..1 | Reference(Encounter) | Encounter associated with event
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication
performer |  | 0..* | BackboneElement | Who performed event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: MedicationDispensePerformerFunctionCodes (example): A code describing the role an individual played in dispensing a medication.
actor |  | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Individual who was performing
location |  | 0..1 | Reference(Location) | Where the dispense occurred
authorizingPrescription |  | 0..* | Reference(MedicationRequest) | Medication order that authorizes the dispense
type |  | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc Binding: ActPharmacySupplyType (example): ActPharmacySupplyType
quantity |  | 1..1 | SimpleQuantity(5.0.0) | Amount dispensed
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | Σ | 1..1 | decimal | Numerical value (with implicit precision)
unit | Σ | 1..1 | string | Unit representation
system | Σ C | 1..1 | uri | System that defines coded unit form
code | Σ C | 1..1 | code | Coded form of the unit
daysSupply |  | 0..1 | SimpleQuantity(5.0.0) | Amount of medication expressed as a timing amount
recorded |  | 1..1 | dateTime | When the recording of the dispense started
whenPrepared | Σ C | 0..1 | dateTime | When product was packaged and reviewed
whenHandedOver | C | 0..1 | dateTime | When product was given out
destination |  | 0..1 | Reference(Location) | Where the medication was/will be sent
receiver |  | 0..* | Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole) | Who collected the medication or where the medication was delivered
note |  | 0..* | Annotation | Information about the dispense
renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions
dosageInstruction |  | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted |  | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
type |  | 0..1 | CodeableConcept | Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): ActSubstanceAdminSubstitutionCode
reason |  | 0..* | CodeableConcept | Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason
responsibleParty |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Who is responsible for the substitution
eventHistory |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.language | Base | required | All Languages | 📍5.0.0 | FHIR Std.
MedicationDispense.status | Base | required | MedicationDispense Status Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.notPerformedReason | Base | example | MedicationDispense Status Reason Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.category | Base | example | MedicationDispense Administration Location Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.medication | Base | required | Dietary Supplements (SNOMED) | 📦1.0.1 | This IG
MedicationDispense.performer.​function | Base | example | MedicationDispense Performer Function Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.type | Base | example | ActPharmacySupplyType | 📦3.0.0 | THO v7.1
MedicationDispense.substitution.​type | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationDispense.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationDispense | 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationDispense | 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 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared | `whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared`

This structure is derived from MedicationDispense

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

- AMK Core Patient Profile (https://fhir.amakomaya.com/StructureDefinition/amk-core-patient)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | Dispensing a medication to a named patient Constraints: mdd-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained |  | 0..* | Resource | Contained, inline Resources
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.
medication | Σ | 1..1 | CodeableReference(Medication) | What medication was supplied Binding: Dietary Supplements (SNOMED) (required)
subject | Σ | 1..1 | Reference(AMK Core Patient Profile) | Who the dispense is for
quantity |  | 1..1 | SimpleQuantity(5.0.0) | Amount dispensed
value | Σ | 1..1 | decimal | Numerical value (with implicit precision)
unit | Σ | 1..1 | string | Unit representation
system | Σ C | 1..1 | uri | System that defines coded unit form
code | Σ C | 1..1 | code | Coded form of the unit
recorded |  | 1..1 | dateTime | When the recording of the dispense started
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.status | Base | required | MedicationDispense Status Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.medication | Base | required | Dietary Supplements (SNOMED) | 📦1.0.1 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationDispense | 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationDispense | 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 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared | `whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared`

Differential View

This structure is derived from MedicationDispense

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense |  | 0..* | MedicationDispense | Dispensing a medication to a named patient
medication |  | 1..1 | CodeableReference(Medication) | What medication was supplied Binding: Dietary Supplements (SNOMED) (required)
subject |  | 1..1 | Reference(AMK Core Patient Profile) | Who the dispense is for
quantity |  | 1..1 | SimpleQuantity(5.0.0) | Amount dispensed
value |  | 1..1 | decimal | Numerical value (with implicit precision)
unit |  | 1..1 | string | Unit representation
system |  | 1..1 | uri | System that defines coded unit form
code |  | 1..1 | code | Coded form of the unit
recorded |  | 1..1 | dateTime | When the recording of the dispense started
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.medication | Base | required | Dietary Supplements (SNOMED) | 📦1.0.1 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | Dispensing a medication to a named patient Constraints: mdd-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language
Additional Bindings | Purpose
CommonLanguages | Starter
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External identifier
basedOn |  | 0..* | Reference(CarePlan) | Plan that is fulfilled by this dispense
partOf |  | 0..* | Reference(Procedure | MedicationAdministration) | Event that dispense is part of
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.
notPerformedReason |  | 0..1 | CodeableReference(DetectedIssue) | Why a dispense was not performed Binding: MedicationDispenseStatusReasonCodes (example)
statusChanged |  | 0..1 | dateTime | When the status changed
category |  | 0..* | CodeableConcept | Type of medication dispense Binding: MedicationDispenseAdministrationLocationCodes (example): A code describing where the dispensed medication is expected to be consumed or administered.
medication | Σ | 1..1 | CodeableReference(Medication) | What medication was supplied Binding: Dietary Supplements (SNOMED) (required)
subject | Σ | 1..1 | Reference(AMK Core Patient Profile) | Who the dispense is for
encounter |  | 0..1 | Reference(Encounter) | Encounter associated with event
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication
performer |  | 0..* | BackboneElement | Who performed event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: MedicationDispensePerformerFunctionCodes (example): A code describing the role an individual played in dispensing a medication.
actor |  | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Individual who was performing
location |  | 0..1 | Reference(Location) | Where the dispense occurred
authorizingPrescription |  | 0..* | Reference(MedicationRequest) | Medication order that authorizes the dispense
type |  | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc Binding: ActPharmacySupplyType (example): ActPharmacySupplyType
quantity |  | 1..1 | SimpleQuantity(5.0.0) | Amount dispensed
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
value | Σ | 1..1 | decimal | Numerical value (with implicit precision)
unit | Σ | 1..1 | string | Unit representation
system | Σ C | 1..1 | uri | System that defines coded unit form
code | Σ C | 1..1 | code | Coded form of the unit
daysSupply |  | 0..1 | SimpleQuantity(5.0.0) | Amount of medication expressed as a timing amount
recorded |  | 1..1 | dateTime | When the recording of the dispense started
whenPrepared | Σ C | 0..1 | dateTime | When product was packaged and reviewed
whenHandedOver | C | 0..1 | dateTime | When product was given out
destination |  | 0..1 | Reference(Location) | Where the medication was/will be sent
receiver |  | 0..* | Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole) | Who collected the medication or where the medication was delivered
note |  | 0..* | Annotation | Information about the dispense
renderedDosageInstruction |  | 0..1 | markdown | Full representation of the dosage instructions
dosageInstruction |  | 0..* | Dosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted |  | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
type |  | 0..1 | CodeableConcept | Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): ActSubstanceAdminSubstitutionCode
reason |  | 0..* | CodeableConcept | Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason
responsibleParty |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Who is responsible for the substitution
eventHistory |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationDispense.language | Base | required | All Languages | 📍5.0.0 | FHIR Std.
MedicationDispense.status | Base | required | MedicationDispense Status Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.notPerformedReason | Base | example | MedicationDispense Status Reason Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.category | Base | example | MedicationDispense Administration Location Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.medication | Base | required | Dietary Supplements (SNOMED) | 📦1.0.1 | This IG
MedicationDispense.performer.​function | Base | example | MedicationDispense Performer Function Codes | 📍5.0.0 | FHIR Std.
MedicationDispense.type | Base | example | ActPharmacySupplyType | 📦3.0.0 | THO v7.1
MedicationDispense.substitution.​type | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationDispense.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationDispense | 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationDispense | 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 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared | `whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared`

This structure is derived from MedicationDispense

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

- AMK Core Patient Profile (https://fhir.amakomaya.com/StructureDefinition/amk-core-patient)

Other representations of profile: CSV, Excel, Schematron