Implementation Guide
TI Common
Version 1.5.0-ballot.1 - ballot

Ressourcenprofil: TI Medication dgMP - Detaillierte Beschreibungen

Active Stand: 2026-09-23

Definitionen für das ti-medication-dgmp ressourcenprofil

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

0. Medication
Definition

This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

ShortDefinition of a Medication
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())
ti-med-1: Medication code, name, or ingredients must be specified (code.exists() or ingredient.exists())
dom-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())
2. Medication.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..1
This element is affected by the following invariants: ele-1
TypeMeta
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Medication.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

ShortVersion specific identifier
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Control0..1
Typeid
Is Modifierfalse
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()))
6. Medication.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

ShortWhen the resource version last changed
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Control0..1
Typeinstant
Is Modifierfalse
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()))
8. Medication.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()))
10. Medication.contained
Definition

This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.


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.

ShortEnthält PZN-Bestandteile für Rezepturen sowie pharmazeutische Produkte im Falle einer Kombipackung.Contained, 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..*
TypeMedicationResource(TI Pharmaceutical Product Medication dgMP, TI Medication PZN Ingredient dgMP)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
12. Medication.extension:context
Slice Namecontext
Definition

Extension for indicating the context.

ShortExtension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(ContextExtension) (Extension Type: code)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Medication.extension:rxPrescriptionProcessIdentifier
Slice NamerxPrescriptionProcessIdentifier
Definition

This extension is used to track medication prescription transactions between the E-Rezept-Fachdienst and the ePA. The RxPrescriptionProcessIdentifier is generated by the ePA Medication Service and consists of the PrescriptionId and the authoredOn date of the operation parameters request. It ensures consistent referencing and management of medication-related resources across different systems.

ShortExtension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(RxPrescriptionProcessIdentifierExtension) (Extension Type: Identifier(RxPrescriptionProcessIdentifier))
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Medication.extension:isVaccine
Slice NameisVaccine
Definition

Indicator of whether this is a vaccine.

ShortExtension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(MedicationIsVaccineExtension) (Extension Type: boolean)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Medication.extension:drugCategory
Slice NamedrugCategory
Definition

Extension for indicating the medication category.

ShortExtension
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(DrugCategoryExtension) (Extension Type: Coding)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. Medication.extension:drugCategory.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*
This element is affected by the following invariants: ele-1
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Medication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 22. Medication.extension:drugCategory.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
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension
    24. Medication.extension:drugCategory.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
    Control10..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from For codes, see https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs
    (required to https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs)
    TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, 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
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Medication.extension:drugCategory.value[x].system
    Definition

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

    ShortIdentity 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.

    Control10..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    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()))
    28. Medication.extension:drugCategory.value[x].code
    Definition

    Drug Category


    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).

    ShortCategorySymbol 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
    Must Supporttrue
    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()))
    30. Medication.extension:normSizeCode
    Slice NamenormSizeCode
    Definition

    Description of the therapy-appropriate package size (e.g., N1)

    ShortPackage size according to N-designation
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(ExtensionNormgroesseDeBasis) (Extension Type: code)
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    32. Medication.extension:normSizeCode.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..0*
    This element is affected by the following invariants: ele-1
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Medication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 34. Medication.extension:normSizeCode.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
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttp://fhir.de/StructureDefinition/normgroesse
      36. Medication.extension:normSizeCode.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
      This element is affected by the following invariants: ele-1
      BindingThe codes SHALL be taken from For codes, see https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE
      (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE)
      Typecode, 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, 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
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Medication.extension:packaging
      Slice Namepackaging
      Definition

      Information on the packaging of a formulation.

      ShortExtension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(MedicationFormulationPackagingExtension) (Extension Type: string)
      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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      40. Medication.extension:manufacturingInstructions
      Slice NamemanufacturingInstructions
      Definition

      Manufacturing instructions regarding the preparation of a formulation (Subscriptio).

      ShortExtension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(MedicationManufacturingInstructionsExtension) (Extension Type: string)
      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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      42. Medication.extension:type
      Slice Nametype
      Definition

      Extension for EPAMedication types

      ShortMedication Type
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Medication Type) (Extension Type: Coding)
      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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      44. Medication.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..*
      This element is affected by the following invariants: ele-1
      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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Medication.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 46. Medication.identifier
        Definition

        Business identifier for this medication.

        ShortBusiness identifier for this medication
        Comments

        The serial number could be included as an identifier.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        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 Medication.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ $this
        • 48. Medication.identifier:RxOriginatorProcessIdentifier
          Slice NameRxOriginatorProcessIdentifier
          Definition

          Business identifier for this medication.

          ShortBusiness identifier for this medication
          Comments

          The serial number could be included as an identifier.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1*
          This element is affected by the following invariants: ele-1
          TypeIdentifier(RxOriginatorProcessIdentifier)
          Is Modifierfalse
          Summarytrue
          Pattern Value{
            "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Medication.code
          Definition

          A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.

          ShortMedication in coded form or as free text if necessaryCodes that identify this medication
          Comments

          Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
          (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

          A coded concept that defines the type of a medication.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Medication.code.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode 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.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          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()))
          SlicingThis element introduces a set of slices on Medication.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ $this
          • 54. Medication.code.coding:pzn
            Slice Namepzn
            Definition

            A reference to a code defined by a terminology system.

            ShortCode 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.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

            Pattern Value{
              "system" : "http://fhir.de/CodeSystem/ifa/pzn"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Medication.code.coding:pzn.system
            Definition

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

            ShortIdentity 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.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            58. Medication.code.coding:pzn.code
            Definition

            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).

            ShortSymbol 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
            Must Supporttrue
            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()))
            60. Medication.code.coding:pzn.display
            Definition

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

            ShortRepresentation defined by the system
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            62. Medication.code.coding:atc-de
            Slice Nameatc-de
            Definition

            A reference to a code defined by a terminology system.

            ShortCode 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.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

            Pattern Value{
              "system" : "http://fhir.de/CodeSystem/bfarm/atc"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. Medication.code.coding:atc-de.system
            Definition

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

            ShortIdentity 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.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            66. Medication.code.coding:atc-de.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)
            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()))
            68. Medication.code.coding:atc-de.code
            Definition

            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).

            ShortSymbol 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
            Must Supporttrue
            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()))
            70. Medication.code.coding:atc-de.display
            Definition

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

            ShortRepresentation defined by the system
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            72. Medication.code.coding:ask
            Slice Nameask
            Definition

            A reference to a code defined by a terminology system.

            ShortCode 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.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

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

            Pattern Value{
              "system" : "http://fhir.de/CodeSystem/ask"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. Medication.code.coding:ask.system
            Definition

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

            ShortIdentity 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.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            76. Medication.code.coding:ask.code
            Definition

            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).

            ShortSymbol 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
            Must Supporttrue
            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()))
            78. Medication.code.coding:ask.display
            Definition

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

            ShortRepresentation defined by the system
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            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()))
            80. Medication.code.text
            Definition

            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.

            ShortPlain 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
            Must Supporttrue
            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()))
            82. Medication.status
            Definition

            A code to indicate if the medication is in active use.

            ShortStatus of Medication Informationactive | inactive | entered-in-error
            Comments

            This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

            Control0..1
            BindingThe codes SHALL be taken from Medication Status Codeshttp://hl7.org/fhir/ValueSet/medication-status|4.0.1
            (required to http://hl7.org/fhir/ValueSet/medication-status|4.0.1)

            A coded concept defining if the medication is in active use.

            Typecode
            Is Modifiertrue because This element changes the interpretation of all descriptive attributes.
            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()))
            84. Medication.manufacturer
            Definition

            Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.

            ShortManufacturer of the MedicationManufacturer of the item
            Comments

            Here, the actual manufacturer of the medication can be named, primarily in the case of active ingredient mixtures (compounding prescriptions), such as the hospital pharmacy. It is important to note that the licensing organization, as mentioned in the PZN (Pharmaceutical Central Number) data, is not considered the manufacturer.


            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeReference(Organization)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
            86. Medication.manufacturer.display
            Definition

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

            ShortText 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
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. Medication.form
            Definition

            Describes the form of the item. Powder; tablets; capsule.

            ShortForm of Dispensingpowder | tablets | capsule +
            Comments

            When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

            Control0..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see SNOMEDCTFormCodeshttp://hl7.org/fhir/ValueSet/medication-form-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/medication-form-codes|4.0.1)

            A coded concept defining the form of a medication.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. Medication.form.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..*
            This element is affected by the following invariants: ele-1
            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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Medication.form.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 92. Medication.form.extension:dataAbsentReason
              Slice NamedataAbsentReason
              Definition

              Provides a reason why the expected value or elements in the element that is extended are missing.

              Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Data Absent Reason) (Extension Type: code)
              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())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              94. Medication.form.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode 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.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              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()))
              SlicingThis element introduces a set of slices on Medication.form.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ $this
              • 96. Medication.form.coding:kbvDarreichungsform
                Slice NamekbvDarreichungsform
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                KBV updates its "Schüsseltabellen" package more often than ePA versions get released. However, the eRezept clients and eRezept service take over new KBV package versions quickly after release and thus hands them over to the ePA Medication Service. Since the Medication Service is potentially fixed onto an older version of the KBV package, it would reject the forwarded eRezept data. In the future, the Medication Service will be enabled to update to the latest KBV package versions without the need for a new ePA release. Since the eRezept does check the codes against the latest KBV package version, the Medication Service will not receive any "invalid" codes and clients can rely on the Medication Service data conforming to the latest KBV package.


                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.

                Control0..1*
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from For codes, see https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM
                (required to https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM)
                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Pattern Value{
                  "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                98. Medication.form.coding:kbvDarreichungsform.system
                Definition

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

                ShortIdentity 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.

                Control10..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                100. Medication.form.coding:kbvDarreichungsform.code
                Definition

                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).

                ShortSymbol 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
                Must Supporttrue
                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()))
                102. Medication.form.coding:kbvDarreichungsform.display
                Definition

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

                ShortRepresentation defined by the system
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                104. Medication.form.coding:ifaDarreichungsform
                Slice NameifaDarreichungsform
                Definition

                A reference to a code defined by a terminology system.

                ShortCode 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.

                Control0..1*
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from For codes, see https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM
                (required to https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM)
                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

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

                Pattern Value{
                  "system" : "https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. Medication.form.coding:ifaDarreichungsform.system
                Definition

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

                ShortIdentity 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.

                Control10..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                108. Medication.form.coding:ifaDarreichungsform.code
                Definition

                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).

                ShortSymbol 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
                Must Supporttrue
                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()))
                110. Medication.form.coding:ifaDarreichungsform.display
                Definition

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

                ShortRepresentation defined by the system
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                112. Medication.form.text
                Definition

                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.

                ShortPlain 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
                Must Supporttrue
                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()))
                114. Medication.amount
                Definition

                Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.).

                ShortAmount of drug in package
                Comments

                The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeRatio
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                116. Medication.amount.numerator
                Definition

                The value of the numerator.

                ShortNumerator value
                Comments

                The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHOULD be taken from For codes, see UCUMCodes
                (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                TypeQuantity
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                118. Medication.amount.numerator.extension:packagingSize
                Slice NamepackagingSize
                Definition

                Specification of the package size according to divided quantity (e.g., 100, 2x25), only appears in conjunction with "unit" (e.g., 100 Stück).

                ShortExtension
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(MedicationPackagingSizeExtension) (Extension Type: string)
                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())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                120. Medication.amount.numerator.extension:totalQuantity
                Slice NametotalQuantity
                Definition

                Total quantity of the formulation (without the unit).

                ShortExtension
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(MedicationTotalQuantityFormulationExtension) (Extension Type: string)
                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())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                122. Medication.amount.numerator.comparator
                Definition

                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..1
                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()))
                124. Medication.amount.denominator
                Definition

                The value of the denominator.

                ShortDenominator value
                Comments

                The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHOULD be taken from For codes, see UCUMCodes
                (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                TypeQuantity
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                126. Medication.amount.denominator.value
                Definition

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

                ShortNumerical 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).

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                128. Medication.amount.denominator.comparator
                Definition

                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..1
                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()))
                130. Medication.amount.denominator.unit
                Definition

                A human-readable form of the unit.

                ShortUnit representation
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                132. Medication.amount.denominator.system
                Definition

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

                ShortSystem that defines coded unit form
                Comments

                see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                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
                Must Supporttrue
                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()))
                134. Medication.amount.denominator.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
                Must Supporttrue
                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()))
                136. Medication.ingredient
                Definition

                Identifies a particular constituent of interest in the product.

                ShortActive or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
                Comments

                The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                138. Medication.ingredient.extension:darreichungsform
                Slice Namedarreichungsform
                Definition

                Dosage form of an ingredient in a formulation.

                ShortExtension
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(MedicationIngredientDarreichungsformExtension) (Extension Type: string)
                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())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                140. Medication.ingredient.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..*
                This element is affected by the following invariants: ele-1
                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())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                142. Medication.ingredient.item[x]
                Definition

                The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

                ShortThe actual ingredient or content
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeChoice of: CodeableConcept, Reference(Substance, Medication)
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Requirements

                The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

                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 Medication.ingredient.item[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 144. Medication.ingredient.item[x]:itemCodeableConcept
                  Slice NameitemCodeableConcept
                  Definition

                  The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

                  ShortEncoded description of the substance or component.The actual ingredient or content
                  Control01..1
                  This element is affected by the following invariants: ele-1
                  TypeCodeableConcept, Reference(Substance, Medication)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Requirements

                  The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  146. Medication.ingredient.item[x]:itemCodeableConcept.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode 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.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeCoding
                  Is Modifierfalse
                  Must Supporttrue
                  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()))
                  SlicingThis element introduces a set of slices on Medication.ingredient.item[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ $this
                  • 148. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask
                    Slice Nameask
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode 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.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeCoding
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

                    Pattern Value{
                      "system" : "http://fhir.de/CodeSystem/ask"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    150. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.system
                    Definition

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

                    ShortIdentity 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.

                    Control10..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    152. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.code
                    Definition

                    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).

                    ShortSymbol 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
                    Must Supporttrue
                    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()))
                    154. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.display
                    Definition

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

                    ShortRepresentation defined by the system
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    156. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de
                    Slice Nameatc-de
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode 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.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeCoding
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

                    Pattern Value{
                      "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    158. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.system
                    Definition

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

                    ShortIdentity 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.

                    Control10..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    160. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.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)
                    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()))
                    162. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.code
                    Definition

                    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).

                    ShortSymbol 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
                    Must Supporttrue
                    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()))
                    164. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.display
                    Definition

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

                    ShortRepresentation defined by the system
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    166. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn
                    Slice Namepzn
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode 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.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeCoding
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

                    Pattern Value{
                      "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    168. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.system
                    Definition

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

                    ShortIdentity 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.

                    Control10..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    170. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.code
                    Definition

                    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).

                    ShortSymbol 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
                    Must Supporttrue
                    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()))
                    172. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.display
                    Definition

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

                    ShortRepresentation defined by the system
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    174. Medication.ingredient.item[x]:itemCodeableConcept.text
                    Definition

                    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.

                    ShortPlain 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
                    Must Supporttrue
                    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()))
                    176. Medication.ingredient.item[x]:itemReference
                    Slice NameitemReference
                    Definition

                    The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

                    ShortRestricted EPAMedicationPZNIngredient & EPAMedicationPharmaceuticalProduct onlyThe actual ingredient or content
                    Control01..1
                    This element is affected by the following invariants: ele-1
                    TypeReference(Medication, Substance, Medication), CodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Requirements

                    The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

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

                    Indication of whether this ingredient affects the therapeutic action of the drug.

                    ShortIs it an active ingredient?Active ingredient indicator
                    Control0..1
                    Typeboolean
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).

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

                    Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.

                    ShortStrengthQuantity of ingredient present
                    Comments

                    The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeRatio
                    Is Modifierfalse
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                    182. Medication.ingredient.strength.extension:amountText
                    Slice NameamountText
                    Definition

                    Free-text amount of the ingredient for classical Latin notations such as "ad 100.0" or "quantum satis," including the unit.

                    ShortExtension
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(MedicationIngredientAmountExtensions) (Extension Type: string)
                    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())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    184. Medication.ingredient.strength.numerator
                    Definition

                    The value of the numerator.

                    ShortNumerator value
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHOULD be taken from For codes, see UCUMCodes
                    (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    186. Medication.ingredient.strength.numerator.value
                    Definition

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

                    ShortNumerical 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
                    Must Supporttrue
                    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()))
                    188. Medication.ingredient.strength.numerator.comparator
                    Definition

                    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..1
                    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()))
                    190. Medication.ingredient.strength.numerator.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    192. Medication.ingredient.strength.numerator.system
                    Definition

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

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    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
                    Must Supporttrue
                    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()))
                    194. Medication.ingredient.strength.numerator.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
                    Must Supporttrue
                    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()))
                    196. Medication.ingredient.strength.denominator
                    Definition

                    The value of the denominator.

                    ShortDenominator value
                    Comments

                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    BindingThe codes SHOULD be taken from For codes, see UCUMCodes
                    (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                    TypeQuantity
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                    198. Medication.ingredient.strength.denominator.value
                    Definition

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

                    ShortNumerical 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
                    Must Supporttrue
                    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()))
                    200. Medication.ingredient.strength.denominator.comparator
                    Definition

                    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..1
                    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()))
                    202. Medication.ingredient.strength.denominator.unit
                    Definition

                    A human-readable form of the unit.

                    ShortUnit representation
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    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()))
                    204. Medication.ingredient.strength.denominator.system
                    Definition

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

                    ShortSystem that defines coded unit form
                    Comments

                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                    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
                    Must Supporttrue
                    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()))
                    206. Medication.ingredient.strength.denominator.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
                    Must Supporttrue
                    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()))
                    208. Medication.batch
                    Definition

                    Information that only applies to packages (not products).

                    ShortDetails about packaged medications
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    210. Medication.batch.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..*
                    This element is affected by the following invariants: ele-1
                    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())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    212. Medication.batch.lotNumber
                    Definition

                    The assigned lot number of a batch of the specified product.

                    ShortIdentifier assigned to batch
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    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. Medication
                    Invariantsti-med-1: Medication code, name, or ingredients must be specified (code.exists() or ingredient.exists())
                    2. Medication.meta
                    Must Supporttrue
                    4. Medication.meta.versionId
                    Must Supporttrue
                    6. Medication.meta.lastUpdated
                    Must Supporttrue
                    8. Medication.contained
                    ShortEnthält PZN-Bestandteile für Rezepturen sowie pharmazeutische Produkte im Falle einer Kombipackung.
                    TypeMedication(TI Pharmaceutical Product Medication dgMP, TI Medication PZN Ingredient dgMP)
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    10. Medication.extension:context
                    Slice Namecontext
                    Control0..1
                    TypeExtension(ContextExtension) (Extension Type: code)
                    Must Supporttrue
                    12. Medication.extension:rxPrescriptionProcessIdentifier
                    Slice NamerxPrescriptionProcessIdentifier
                    Control0..1
                    TypeExtension(RxPrescriptionProcessIdentifierExtension) (Extension Type: Identifier(RxPrescriptionProcessIdentifier))
                    Must Supporttrue
                    14. Medication.extension:isVaccine
                    Slice NameisVaccine
                    Control0..1
                    TypeExtension(MedicationIsVaccineExtension) (Extension Type: boolean)
                    Must Supporttrue
                    16. Medication.extension:drugCategory
                    Slice NamedrugCategory
                    Control0..1
                    TypeExtension(DrugCategoryExtension) (Extension Type: Coding)
                    Must Supporttrue
                    18. Medication.extension:drugCategory.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    20. Medication.extension:drugCategory.value[x].system
                    Control1..?
                    Must Supporttrue
                    22. Medication.extension:drugCategory.value[x].code
                    Control1..?
                    Must Supporttrue
                    24. Medication.extension:normSizeCode
                    Slice NamenormSizeCode
                    Definition

                    Description of the therapy-appropriate package size (e.g., N1)

                    ShortPackage size according to N-designation
                    Control0..1
                    TypeExtension(ExtensionNormgroesseDeBasis) (Extension Type: code)
                    Must Supporttrue
                    26. Medication.extension:normSizeCode.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Must Supporttrue
                    28. Medication.extension:packaging
                    Slice Namepackaging
                    Control0..1
                    TypeExtension(MedicationFormulationPackagingExtension) (Extension Type: string)
                    Must Supporttrue
                    30. Medication.extension:manufacturingInstructions
                    Slice NamemanufacturingInstructions
                    Control0..1
                    TypeExtension(MedicationManufacturingInstructionsExtension) (Extension Type: string)
                    Must Supporttrue
                    32. Medication.extension:type
                    Slice Nametype
                    Control0..1
                    TypeExtension(Medication Type) (Extension Type: Coding)
                    Must Supporttrue
                    34. Medication.identifier
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    SlicingThis element introduces a set of slices on Medication.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ $this
                    • 36. Medication.identifier:RxOriginatorProcessIdentifier
                      Slice NameRxOriginatorProcessIdentifier
                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      TypeIdentifier(RxOriginatorProcessIdentifier)
                      Pattern Value{
                        "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
                      }
                      38. Medication.code
                      ShortMedication in coded form or as free text if necessary
                      Must Supporttrue
                      40. Medication.code.coding
                      Must Supporttrue
                      SlicingThis element introduces a set of slices on Medication.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ $this
                      • 42. Medication.code.coding:pzn
                        Slice Namepzn
                        Control0..1
                        Must Supporttrue
                        Pattern Value{
                          "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                        }
                        44. Medication.code.coding:pzn.system
                        Control1..?
                        Must Supporttrue
                        46. Medication.code.coding:pzn.code
                        Control1..?
                        Must Supporttrue
                        48. Medication.code.coding:pzn.display
                        Must Supporttrue
                        50. Medication.code.coding:atc-de
                        Slice Nameatc-de
                        Control0..*
                        Must Supporttrue
                        Pattern Value{
                          "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                        }
                        52. Medication.code.coding:atc-de.system
                        Control1..?
                        Must Supporttrue
                        54. Medication.code.coding:atc-de.version
                        NoteThis is a business version Id, not a resource version Id (see discussion)
                        Control1..?
                        56. Medication.code.coding:atc-de.code
                        Control1..?
                        Must Supporttrue
                        58. Medication.code.coding:atc-de.display
                        Must Supporttrue
                        60. Medication.code.coding:ask
                        Slice Nameask
                        Control0..*
                        Must Supporttrue
                        Pattern Value{
                          "system" : "http://fhir.de/CodeSystem/ask"
                        }
                        62. Medication.code.coding:ask.system
                        Control1..?
                        Must Supporttrue
                        64. Medication.code.coding:ask.code
                        Control1..?
                        Must Supporttrue
                        66. Medication.code.coding:ask.display
                        Must Supporttrue
                        68. Medication.code.text
                        Must Supporttrue
                        70. Medication.status
                        ShortStatus of Medication Information
                        Must Supporttrue
                        72. Medication.manufacturer
                        ShortManufacturer of the Medication
                        Comments

                        Here, the actual manufacturer of the medication can be named, primarily in the case of active ingredient mixtures (compounding prescriptions), such as the hospital pharmacy. It is important to note that the licensing organization, as mentioned in the PZN (Pharmaceutical Central Number) data, is not considered the manufacturer.

                        Must Supporttrue
                        74. Medication.manufacturer.display
                        Control1..?
                        Must Supporttrue
                        76. Medication.form
                        ShortForm of Dispensing
                        Must Supporttrue
                        78. Medication.form.extension
                        Must Supporttrue
                        80. Medication.form.extension:dataAbsentReason
                        Slice NamedataAbsentReason
                        Control0..1
                        TypeExtension(Data Absent Reason) (Extension Type: code)
                        Must Supporttrue
                        82. Medication.form.coding
                        Must Supporttrue
                        SlicingThis element introduces a set of slices on Medication.form.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ $this
                        • 84. Medication.form.coding:kbvDarreichungsform
                          Slice NamekbvDarreichungsform
                          Comments

                          KBV updates its "Schüsseltabellen" package more often than ePA versions get released. However, the eRezept clients and eRezept service take over new KBV package versions quickly after release and thus hands them over to the ePA Medication Service. Since the Medication Service is potentially fixed onto an older version of the KBV package, it would reject the forwarded eRezept data. In the future, the Medication Service will be enabled to update to the latest KBV package versions without the need for a new ePA release. Since the eRezept does check the codes against the latest KBV package version, the Medication Service will not receive any "invalid" codes and clients can rely on the Medication Service data conforming to the latest KBV package.

                          Control0..1
                          BindingThe codes SHALL be taken from https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM
                          (required to https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM)
                          Must Supporttrue
                          Pattern Value{
                            "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"
                          }
                          86. Medication.form.coding:kbvDarreichungsform.system
                          Control1..?
                          Must Supporttrue
                          88. Medication.form.coding:kbvDarreichungsform.code
                          Control1..?
                          Must Supporttrue
                          90. Medication.form.coding:kbvDarreichungsform.display
                          Must Supporttrue
                          92. Medication.form.coding:ifaDarreichungsform
                          Slice NameifaDarreichungsform
                          Control0..1
                          BindingThe codes SHALL be taken from https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM
                          (required to https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM)
                          Must Supporttrue
                          Pattern Value{
                            "system" : "https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM"
                          }
                          94. Medication.form.coding:ifaDarreichungsform.system
                          Control1..?
                          Must Supporttrue
                          96. Medication.form.coding:ifaDarreichungsform.code
                          Control1..?
                          Must Supporttrue
                          98. Medication.form.coding:ifaDarreichungsform.display
                          Must Supporttrue
                          100. Medication.form.text
                          Must Supporttrue
                          102. Medication.amount
                          Must Supporttrue
                          104. Medication.amount.numerator
                          BindingThe codes SHOULD be taken from UCUMCodes
                          (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                          Must Supporttrue
                          106. Medication.amount.numerator.extension:packagingSize
                          Slice NamepackagingSize
                          Control0..1
                          TypeExtension(MedicationPackagingSizeExtension) (Extension Type: string)
                          Must Supporttrue
                          108. Medication.amount.numerator.extension:totalQuantity
                          Slice NametotalQuantity
                          Control0..1
                          TypeExtension(MedicationTotalQuantityFormulationExtension) (Extension Type: string)
                          Must Supporttrue
                          110. Medication.amount.denominator
                          BindingThe codes SHOULD be taken from UCUMCodes
                          (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                          Must Supporttrue
                          112. Medication.amount.denominator.value
                          Must Supporttrue
                          114. Medication.amount.denominator.unit
                          Must Supporttrue
                          116. Medication.amount.denominator.system
                          Must Supporttrue
                          118. Medication.amount.denominator.code
                          Must Supporttrue
                          120. Medication.ingredient
                          ShortActive or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
                          Must Supporttrue
                          122. Medication.ingredient.extension:darreichungsform
                          Slice Namedarreichungsform
                          Control0..1
                          TypeExtension(MedicationIngredientDarreichungsformExtension) (Extension Type: string)
                          124. Medication.ingredient.item[x]
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Must Supporttrue
                          SlicingThis element introduces a set of slices on Medication.ingredient.item[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 126. Medication.ingredient.item[x]:itemCodeableConcept
                            Slice NameitemCodeableConcept
                            ShortEncoded description of the substance or component.
                            Control0..1
                            TypeCodeableConcept
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Must Supporttrue
                            128. Medication.ingredient.item[x]:itemCodeableConcept.coding
                            Must Supporttrue
                            SlicingThis element introduces a set of slices on Medication.ingredient.item[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ $this
                            • 130. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask
                              Slice Nameask
                              Control0..*
                              Must Supporttrue
                              Pattern Value{
                                "system" : "http://fhir.de/CodeSystem/ask"
                              }
                              132. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.system
                              Control1..?
                              Must Supporttrue
                              134. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.code
                              Control1..?
                              Must Supporttrue
                              136. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.display
                              Must Supporttrue
                              138. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de
                              Slice Nameatc-de
                              Control0..*
                              Must Supporttrue
                              Pattern Value{
                                "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                              }
                              140. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.system
                              Control1..?
                              Must Supporttrue
                              142. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.version
                              NoteThis is a business version Id, not a resource version Id (see discussion)
                              Control1..?
                              144. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.code
                              Control1..?
                              Must Supporttrue
                              146. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.display
                              Must Supporttrue
                              148. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn
                              Slice Namepzn
                              Control0..*
                              Must Supporttrue
                              Pattern Value{
                                "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                              }
                              150. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.system
                              Control1..?
                              Must Supporttrue
                              152. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.code
                              Control1..?
                              Must Supporttrue
                              154. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.display
                              Must Supporttrue
                              156. Medication.ingredient.item[x]:itemCodeableConcept.text
                              Must Supporttrue
                              158. Medication.ingredient.item[x]:itemReference
                              Slice NameitemReference
                              ShortRestricted EPAMedicationPZNIngredient & EPAMedicationPharmaceuticalProduct only
                              Control0..1
                              TypeReference(Medication)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Must Supporttrue
                              160. Medication.ingredient.isActive
                              ShortIs it an active ingredient?
                              162. Medication.ingredient.strength
                              ShortStrength
                              Must Supporttrue
                              164. Medication.ingredient.strength.extension:amountText
                              Slice NameamountText
                              Control0..1
                              TypeExtension(MedicationIngredientAmountExtensions) (Extension Type: string)
                              166. Medication.ingredient.strength.numerator
                              BindingThe codes SHOULD be taken from UCUMCodes
                              (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                              Must Supporttrue
                              168. Medication.ingredient.strength.numerator.value
                              Control1..?
                              Must Supporttrue
                              170. Medication.ingredient.strength.numerator.unit
                              Must Supporttrue
                              172. Medication.ingredient.strength.numerator.system
                              Must Supporttrue
                              174. Medication.ingredient.strength.numerator.code
                              Must Supporttrue
                              176. Medication.ingredient.strength.denominator
                              BindingThe codes SHOULD be taken from UCUMCodes
                              (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                              Must Supporttrue
                              178. Medication.ingredient.strength.denominator.value
                              Control1..?
                              Must Supporttrue
                              180. Medication.ingredient.strength.denominator.unit
                              Must Supporttrue
                              182. Medication.ingredient.strength.denominator.system
                              Must Supporttrue
                              184. Medication.ingredient.strength.denominator.code
                              Must Supporttrue
                              186. Medication.batch
                              Must Supporttrue
                              188. Medication.batch.lotNumber
                              Must Supporttrue

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

                              0. Medication
                              Definition

                              This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

                              ShortDefinition of a Medication
                              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())
                              ti-med-1: Medication code, name, or ingredients must be specified (code.exists() or ingredient.exists())
                              2. Medication.id
                              Definition

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

                              ShortLogical id of this artifact
                              Comments

                              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
                              Typeid
                              Is Modifierfalse
                              Summarytrue
                              4. Medication.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..1
                              TypeMeta
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              6. Medication.meta.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
                              8. Medication.meta.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 Medication.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 10. Medication.meta.versionId
                                Definition

                                The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                                ShortVersion specific identifier
                                Comments

                                The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                                Control0..1
                                Typeid
                                Is Modifierfalse
                                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()))
                                12. Medication.meta.lastUpdated
                                Definition

                                When the resource last changed - e.g. when the version changed.

                                ShortWhen the resource version last changed
                                Comments

                                This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                                Control0..1
                                Typeinstant
                                Is Modifierfalse
                                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()))
                                14. Medication.meta.source
                                Definition

                                A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                                ShortIdentifies where the resource comes from
                                Comments

                                In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                                This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                                Control0..1
                                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()))
                                16. Medication.meta.profile
                                Definition

                                A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                                ShortProfiles this resource claims to conform to
                                Comments

                                It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                                Control0..*
                                Typecanonical(StructureDefinition)
                                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()))
                                18. Medication.meta.security
                                Definition

                                Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                                ShortSecurity Labels applied to this resource
                                Comments

                                The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                                (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                                Security Labels from the Healthcare Privacy and Security Classification System.

                                TypeCoding
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                20. Medication.meta.tag
                                Definition

                                Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                                ShortTags applied to this resource
                                Comments

                                The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                BindingFor example codes, see CommonTags
                                (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

                                Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                                TypeCoding
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                22. Medication.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()))
                                24. Medication.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()))
                                26. Medication.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()))
                                28. Medication.contained
                                Definition

                                This resource is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

                                ShortEnthält PZN-Bestandteile für Rezepturen sowie pharmazeutische Produkte im Falle einer Kombipackung.
                                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..*
                                TypeMedication(TI Pharmaceutical Product Medication dgMP, TI Medication PZN Ingredient dgMP)
                                Is Modifierfalse
                                Must Supporttrue
                                Must Support TypesNo must-support rules about the choice of types/profiles
                                Summaryfalse
                                30. Medication.extension
                                Definition

                                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.

                                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 Medication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 32. Medication.extension:context
                                  Slice Namecontext
                                  Definition

                                  Extension for indicating the context.

                                  ShortExtension
                                  Control0..1
                                  TypeExtension(ContextExtension) (Extension Type: code)
                                  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())
                                  34. Medication.extension:rxPrescriptionProcessIdentifier
                                  Slice NamerxPrescriptionProcessIdentifier
                                  Definition

                                  This extension is used to track medication prescription transactions between the E-Rezept-Fachdienst and the ePA. The RxPrescriptionProcessIdentifier is generated by the ePA Medication Service and consists of the PrescriptionId and the authoredOn date of the operation parameters request. It ensures consistent referencing and management of medication-related resources across different systems.

                                  ShortExtension
                                  Control0..1
                                  TypeExtension(RxPrescriptionProcessIdentifierExtension) (Extension Type: Identifier(RxPrescriptionProcessIdentifier))
                                  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())
                                  36. Medication.extension:isVaccine
                                  Slice NameisVaccine
                                  Definition

                                  Indicator of whether this is a vaccine.

                                  ShortExtension
                                  Control0..1
                                  TypeExtension(MedicationIsVaccineExtension) (Extension Type: boolean)
                                  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())
                                  38. Medication.extension:drugCategory
                                  Slice NamedrugCategory
                                  Definition

                                  Extension for indicating the medication category.

                                  ShortExtension
                                  Control0..1
                                  TypeExtension(DrugCategoryExtension) (Extension Type: Coding)
                                  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())
                                  40. Medication.extension:drugCategory.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
                                  42. Medication.extension:drugCategory.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 Medication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 44. Medication.extension:drugCategory.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
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Fixed Valuehttps://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension
                                    46. Medication.extension:drugCategory.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
                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    BindingThe codes SHALL be taken from https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs
                                    (required to https://gematik.de/fhir/terminology/ValueSet/ti-drug-category-vs)
                                    TypeCoding
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    48. Medication.extension:drugCategory.value[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
                                    50. Medication.extension:drugCategory.value[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 Medication.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 52. Medication.extension:drugCategory.value[x].system
                                      Definition

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

                                      ShortIdentity 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.

                                      Control1..1
                                      Typeuri
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      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()))
                                      54. Medication.extension:drugCategory.value[x].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()))
                                      56. Medication.extension:drugCategory.value[x].code
                                      Definition

                                      Drug Category

                                      ShortCategory
                                      Control1..1
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      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()))
                                      58. Medication.extension:drugCategory.value[x].display
                                      Definition

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

                                      ShortRepresentation defined by the system
                                      Comments

                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                      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()))
                                      60. Medication.extension:drugCategory.value[x].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()))
                                      62. Medication.extension:normSizeCode
                                      Slice NamenormSizeCode
                                      Definition

                                      Description of the therapy-appropriate package size (e.g., N1)

                                      ShortPackage size according to N-designation
                                      Control0..1
                                      TypeExtension(ExtensionNormgroesseDeBasis) (Extension Type: code)
                                      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())
                                      64. Medication.extension:normSizeCode.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. Medication.extension:normSizeCode.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..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 Medication.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 68. Medication.extension:normSizeCode.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
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Fixed Valuehttp://fhir.de/StructureDefinition/normgroesse
                                        70. Medication.extension:normSizeCode.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
                                        This element is affected by the following invariants: ele-1
                                        BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE
                                        (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_NORMGROESSE)
                                        Typecode
                                        [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
                                        Must Supporttrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        72. Medication.extension:packaging
                                        Slice Namepackaging
                                        Definition

                                        Information on the packaging of a formulation.

                                        ShortExtension
                                        Control0..1
                                        TypeExtension(MedicationFormulationPackagingExtension) (Extension Type: string)
                                        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())
                                        74. Medication.extension:manufacturingInstructions
                                        Slice NamemanufacturingInstructions
                                        Definition

                                        Manufacturing instructions regarding the preparation of a formulation (Subscriptio).

                                        ShortExtension
                                        Control0..1
                                        TypeExtension(MedicationManufacturingInstructionsExtension) (Extension Type: string)
                                        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())
                                        76. Medication.extension:type
                                        Slice Nametype
                                        Definition

                                        Extension for EPAMedication types

                                        ShortMedication Type
                                        Control0..1
                                        TypeExtension(Medication Type) (Extension Type: Coding)
                                        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())
                                        78. Medication.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())
                                        SlicingThis element introduces a set of slices on Medication.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 80. Medication.identifier
                                          Definition

                                          Business identifier for this medication.

                                          ShortBusiness identifier for this medication
                                          Comments

                                          The serial number could be included as an identifier.

                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Summarytrue
                                          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 Medication.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ $this
                                          • 82. Medication.identifier:RxOriginatorProcessIdentifier
                                            Slice NameRxOriginatorProcessIdentifier
                                            Definition

                                            Business identifier for this medication.

                                            ShortBusiness identifier for this medication
                                            Comments

                                            The serial number could be included as an identifier.

                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeIdentifier(RxOriginatorProcessIdentifier)
                                            Is Modifierfalse
                                            Summarytrue
                                            Pattern Value{
                                              "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            84. Medication.code
                                            Definition

                                            A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems.

                                            ShortMedication in coded form or as free text if necessary
                                            Comments

                                            Depending on the context of use, the code that was actually selected by the user (prescriber, dispenser, etc.) will have the coding.userSelected set to true. As described in the coding datatype: "A coding may be marked as a "userSelected" if a user selected the particular coded value in a user interface (e.g. the user selects an item in a pick-list). If a user selected coding exists, it is the preferred choice for performing translations etc. Other codes can only be literal translations to alternative code systems, or codes at a lower level of granularity (e.g. a generic code for a vendor-specific primary one).

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see SNOMEDCTMedicationCodes
                                            (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                                            A coded concept that defines the type of a medication.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            86. Medication.code.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
                                            88. Medication.code.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 Medication.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 90. Medication.code.coding
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode 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.

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeCoding
                                              Is Modifierfalse
                                              Must Supporttrue
                                              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()))
                                              SlicingThis element introduces a set of slices on Medication.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ $this
                                              • 92. Medication.code.coding:pzn
                                                Slice Namepzn
                                                Definition

                                                A reference to a code defined by a terminology system.

                                                ShortCode 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.

                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeCoding
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summarytrue
                                                Requirements

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

                                                Pattern Value{
                                                  "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                94. Medication.code.coding:pzn.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
                                                96. Medication.code.coding:pzn.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 Medication.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 98. Medication.code.coding:pzn.system
                                                  Definition

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

                                                  ShortIdentity 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.

                                                  Control1..1
                                                  Typeuri
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  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()))
                                                  100. Medication.code.coding:pzn.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()))
                                                  102. Medication.code.coding:pzn.code
                                                  Definition

                                                  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).

                                                  ShortSymbol in syntax defined by the system
                                                  Control1..1
                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  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()))
                                                  104. Medication.code.coding:pzn.display
                                                  Definition

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

                                                  ShortRepresentation defined by the system
                                                  Comments

                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  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()))
                                                  106. Medication.code.coding:pzn.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()))
                                                  108. Medication.code.coding:atc-de
                                                  Slice Nameatc-de
                                                  Definition

                                                  A reference to a code defined by a terminology system.

                                                  ShortCode 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.

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summarytrue
                                                  Requirements

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

                                                  Pattern Value{
                                                    "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  110. Medication.code.coding:atc-de.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
                                                  112. Medication.code.coding:atc-de.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 Medication.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 114. Medication.code.coding:atc-de.system
                                                    Definition

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

                                                    ShortIdentity 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.

                                                    Control1..1
                                                    Typeuri
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    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()))
                                                    116. Medication.code.coding:atc-de.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)
                                                    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()))
                                                    118. Medication.code.coding:atc-de.code
                                                    Definition

                                                    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).

                                                    ShortSymbol in syntax defined by the system
                                                    Control1..1
                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    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()))
                                                    120. Medication.code.coding:atc-de.display
                                                    Definition

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

                                                    ShortRepresentation defined by the system
                                                    Comments

                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    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()))
                                                    122. Medication.code.coding:atc-de.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()))
                                                    124. Medication.code.coding:ask
                                                    Slice Nameask
                                                    Definition

                                                    A reference to a code defined by a terminology system.

                                                    ShortCode 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.

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeCoding
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summarytrue
                                                    Requirements

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

                                                    Pattern Value{
                                                      "system" : "http://fhir.de/CodeSystem/ask"
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    126. Medication.code.coding:ask.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
                                                    128. Medication.code.coding:ask.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 Medication.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 130. Medication.code.coding:ask.system
                                                      Definition

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

                                                      ShortIdentity 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.

                                                      Control1..1
                                                      Typeuri
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      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()))
                                                      132. Medication.code.coding:ask.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()))
                                                      134. Medication.code.coding:ask.code
                                                      Definition

                                                      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).

                                                      ShortSymbol in syntax defined by the system
                                                      Control1..1
                                                      Typecode
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      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()))
                                                      136. Medication.code.coding:ask.display
                                                      Definition

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

                                                      ShortRepresentation defined by the system
                                                      Comments

                                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      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()))
                                                      138. Medication.code.coding:ask.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()))
                                                      140. Medication.code.text
                                                      Definition

                                                      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.

                                                      ShortPlain 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
                                                      Must Supporttrue
                                                      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()))
                                                      142. Medication.status
                                                      Definition

                                                      A code to indicate if the medication is in active use.

                                                      ShortStatus of Medication Information
                                                      Comments

                                                      This status is intended to identify if the medication in a local system is in active use within a drug database or inventory. For example, a pharmacy system may create a new drug file record for a compounded product "ABC Hospital Special Cream" with an active status. At some point in the future, it may be determined that the drug record was created with an error and the status is changed to "entered in error". This status is not intended to specify if a medication is part of a particular formulary. It is possible that the drug record may be referenced by multiple formularies or catalogues and each of those entries would have a separate status.

                                                      Control0..1
                                                      BindingThe codes SHALL be taken from Medication Status Codes
                                                      (required to http://hl7.org/fhir/ValueSet/medication-status|4.0.1)

                                                      A coded concept defining if the medication is in active use.

                                                      Typecode
                                                      Is Modifiertrue because This element changes the interpretation of all descriptive attributes.
                                                      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()))
                                                      144. Medication.manufacturer
                                                      Definition

                                                      Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product.

                                                      ShortManufacturer of the Medication
                                                      Comments

                                                      Here, the actual manufacturer of the medication can be named, primarily in the case of active ingredient mixtures (compounding prescriptions), such as the hospital pharmacy. It is important to note that the licensing organization, as mentioned in the PZN (Pharmaceutical Central Number) data, is not considered the manufacturer.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeReference(Organization)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                      146. Medication.manufacturer.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
                                                      148. Medication.manufacturer.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 Medication.manufacturer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 150. Medication.manufacturer.reference
                                                        Definition

                                                        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.

                                                        ShortLiteral 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.

                                                        Control0..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()))
                                                        152. Medication.manufacturer.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()))
                                                        154. Medication.manufacturer.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
                                                        This element is affected by the following invariants: ele-1
                                                        TypeIdentifier
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        156. Medication.manufacturer.display
                                                        Definition

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

                                                        ShortText 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.

                                                        Control1..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        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()))
                                                        158. Medication.form
                                                        Definition

                                                        Describes the form of the item. Powder; tablets; capsule.

                                                        ShortForm of Dispensing
                                                        Comments

                                                        When Medication is referenced from MedicationRequest, this is the ordered form. When Medication is referenced within MedicationDispense, this is the dispensed form. When Medication is referenced within MedicationAdministration, this is administered form.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        BindingFor example codes, see SNOMEDCTFormCodes
                                                        (example to http://hl7.org/fhir/ValueSet/medication-form-codes|4.0.1)

                                                        A coded concept defining the form of a medication.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        160. Medication.form.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
                                                        162. Medication.form.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        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())
                                                        SlicingThis element introduces a set of slices on Medication.form.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 164. Medication.form.extension:dataAbsentReason
                                                          Slice NamedataAbsentReason
                                                          Definition

                                                          Provides a reason why the expected value or elements in the element that is extended are missing.

                                                          Shortunknown | asked | temp | notasked | masked | unsupported | astext | error
                                                          Control0..1
                                                          TypeExtension(Data Absent Reason) (Extension Type: code)
                                                          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())
                                                          166. Medication.form.coding
                                                          Definition

                                                          A reference to a code defined by a terminology system.

                                                          ShortCode 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.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeCoding
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          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()))
                                                          SlicingThis element introduces a set of slices on Medication.form.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ $this
                                                          • 168. Medication.form.coding:kbvDarreichungsform
                                                            Slice NamekbvDarreichungsform
                                                            Definition

                                                            A reference to a code defined by a terminology system.

                                                            ShortCode defined by a terminology system
                                                            Comments

                                                            KBV updates its "Schüsseltabellen" package more often than ePA versions get released. However, the eRezept clients and eRezept service take over new KBV package versions quickly after release and thus hands them over to the ePA Medication Service. Since the Medication Service is potentially fixed onto an older version of the KBV package, it would reject the forwarded eRezept data. In the future, the Medication Service will be enabled to update to the latest KBV package versions without the need for a new ePA release. Since the eRezept does check the codes against the latest KBV package version, the Medication Service will not receive any "invalid" codes and clients can rely on the Medication Service data conforming to the latest KBV package.

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            BindingThe codes SHALL be taken from https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM
                                                            (required to https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM)
                                                            TypeCoding
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summarytrue
                                                            Requirements

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

                                                            Pattern Value{
                                                              "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            170. Medication.form.coding:kbvDarreichungsform.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
                                                            172. Medication.form.coding:kbvDarreichungsform.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 Medication.form.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 174. Medication.form.coding:kbvDarreichungsform.system
                                                              Definition

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

                                                              ShortIdentity 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.

                                                              Control1..1
                                                              Typeuri
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supporttrue
                                                              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()))
                                                              176. Medication.form.coding:kbvDarreichungsform.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()))
                                                              178. Medication.form.coding:kbvDarreichungsform.code
                                                              Definition

                                                              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).

                                                              ShortSymbol in syntax defined by the system
                                                              Control1..1
                                                              Typecode
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supporttrue
                                                              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()))
                                                              180. Medication.form.coding:kbvDarreichungsform.display
                                                              Definition

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

                                                              ShortRepresentation defined by the system
                                                              Comments

                                                              Note that FHIR strings SHALL NOT exceed 1MB in size

                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supporttrue
                                                              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()))
                                                              182. Medication.form.coding:kbvDarreichungsform.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()))
                                                              184. Medication.form.coding:ifaDarreichungsform
                                                              Slice NameifaDarreichungsform
                                                              Definition

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode 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.

                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              BindingThe codes SHALL be taken from https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM
                                                              (required to https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM)
                                                              TypeCoding
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summarytrue
                                                              Requirements

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

                                                              Pattern Value{
                                                                "system" : "https://fhir.ifaffm.de/CodeSystem/IFA_DARREICHUNGSFORM"
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              186. Medication.form.coding:ifaDarreichungsform.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
                                                              188. Medication.form.coding:ifaDarreichungsform.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 Medication.form.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 190. Medication.form.coding:ifaDarreichungsform.system
                                                                Definition

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

                                                                ShortIdentity 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.

                                                                Control1..1
                                                                Typeuri
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                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()))
                                                                192. Medication.form.coding:ifaDarreichungsform.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()))
                                                                194. Medication.form.coding:ifaDarreichungsform.code
                                                                Definition

                                                                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).

                                                                ShortSymbol in syntax defined by the system
                                                                Control1..1
                                                                Typecode
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                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()))
                                                                196. Medication.form.coding:ifaDarreichungsform.display
                                                                Definition

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

                                                                ShortRepresentation defined by the system
                                                                Comments

                                                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                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()))
                                                                198. Medication.form.coding:ifaDarreichungsform.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()))
                                                                200. Medication.form.text
                                                                Definition

                                                                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.

                                                                ShortPlain 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
                                                                Must Supporttrue
                                                                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()))
                                                                202. Medication.amount
                                                                Definition

                                                                Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.).

                                                                ShortAmount of drug in package
                                                                Comments

                                                                The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeRatio
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                204. Medication.amount.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
                                                                206. Medication.amount.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 Medication.amount.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 208. Medication.amount.numerator
                                                                  Definition

                                                                  The value of the numerator.

                                                                  ShortNumerator value
                                                                  Comments

                                                                  The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  BindingThe codes SHOULD be taken from UCUMCodes
                                                                  (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                                                                  TypeQuantity
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                  210. Medication.amount.numerator.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
                                                                  212. Medication.amount.numerator.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 Medication.amount.numerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 214. Medication.amount.numerator.extension:packagingSize
                                                                    Slice NamepackagingSize
                                                                    Definition

                                                                    Specification of the package size according to divided quantity (e.g., 100, 2x25), only appears in conjunction with "unit" (e.g., 100 Stück).

                                                                    ShortExtension
                                                                    Control0..1
                                                                    TypeExtension(MedicationPackagingSizeExtension) (Extension Type: string)
                                                                    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())
                                                                    216. Medication.amount.numerator.extension:totalQuantity
                                                                    Slice NametotalQuantity
                                                                    Definition

                                                                    Total quantity of the formulation (without the unit).

                                                                    ShortExtension
                                                                    Control0..1
                                                                    TypeExtension(MedicationTotalQuantityFormulationExtension) (Extension Type: string)
                                                                    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())
                                                                    218. Medication.amount.numerator.value
                                                                    Definition

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

                                                                    ShortNumerical 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).

                                                                    Control0..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()))
                                                                    220. Medication.amount.numerator.comparator
                                                                    Definition

                                                                    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..1
                                                                    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()))
                                                                    222. Medication.amount.numerator.unit
                                                                    Definition

                                                                    A human-readable form of the unit.

                                                                    ShortUnit representation
                                                                    Comments

                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                    Control0..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()))
                                                                    224. Medication.amount.numerator.system
                                                                    Definition

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

                                                                    ShortSystem that defines coded unit form
                                                                    Comments

                                                                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                    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()))
                                                                    226. Medication.amount.numerator.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()))
                                                                    228. Medication.amount.denominator
                                                                    Definition

                                                                    The value of the denominator.

                                                                    ShortDenominator value
                                                                    Comments

                                                                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    BindingThe codes SHOULD be taken from UCUMCodes
                                                                    (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                                                                    TypeQuantity
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                    230. Medication.amount.denominator.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
                                                                    232. Medication.amount.denominator.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 Medication.amount.denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 234. Medication.amount.denominator.value
                                                                      Definition

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

                                                                      ShortNumerical 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).

                                                                      Control0..1
                                                                      Typedecimal
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      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()))
                                                                      236. Medication.amount.denominator.comparator
                                                                      Definition

                                                                      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..1
                                                                      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()))
                                                                      238. Medication.amount.denominator.unit
                                                                      Definition

                                                                      A human-readable form of the unit.

                                                                      ShortUnit representation
                                                                      Comments

                                                                      Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      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()))
                                                                      240. Medication.amount.denominator.system
                                                                      Definition

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

                                                                      ShortSystem that defines coded unit form
                                                                      Comments

                                                                      see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                      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
                                                                      Must Supporttrue
                                                                      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()))
                                                                      242. Medication.amount.denominator.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
                                                                      Must Supporttrue
                                                                      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()))
                                                                      244. Medication.ingredient
                                                                      Definition

                                                                      Identifies a particular constituent of interest in the product.

                                                                      ShortActive or inactive ingredients of the medication, including pharmaceutical substances as well as individual medicinal products in combination packs.
                                                                      Comments

                                                                      The ingredients need not be a complete list. If an ingredient is not specified, this does not indicate whether an ingredient is present or absent. If an ingredient is specified it does not mean that all ingredients are specified. It is possible to specify both inactive and active ingredients.

                                                                      Control0..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeBackboneElement
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      246. Medication.ingredient.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
                                                                      248. Medication.ingredient.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 Medication.ingredient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 250. Medication.ingredient.extension:darreichungsform
                                                                        Slice Namedarreichungsform
                                                                        Definition

                                                                        Dosage form of an ingredient in a formulation.

                                                                        ShortExtension
                                                                        Control0..1
                                                                        TypeExtension(MedicationIngredientDarreichungsformExtension) (Extension Type: string)
                                                                        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())
                                                                        252. Medication.ingredient.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())
                                                                        254. Medication.ingredient.item[x]
                                                                        Definition

                                                                        The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

                                                                        ShortThe actual ingredient or content
                                                                        Control1..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeChoice of: CodeableConcept, Reference(Substance, Medication)
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                                                        Requirements

                                                                        The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

                                                                        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 Medication.ingredient.item[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                        • type @ $this
                                                                        • 256. Medication.ingredient.item[x]:itemCodeableConcept
                                                                          Slice NameitemCodeableConcept
                                                                          Definition

                                                                          The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

                                                                          ShortEncoded description of the substance or component.
                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeCodeableConcept
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Requirements

                                                                          The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          258. Medication.ingredient.item[x]:itemCodeableConcept.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
                                                                          260. Medication.ingredient.item[x]:itemCodeableConcept.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 Medication.ingredient.item[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 262. Medication.ingredient.item[x]:itemCodeableConcept.coding
                                                                            Definition

                                                                            A reference to a code defined by a terminology system.

                                                                            ShortCode 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.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeCoding
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            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()))
                                                                            SlicingThis element introduces a set of slices on Medication.ingredient.item[x].coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ $this
                                                                            • 264. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask
                                                                              Slice Nameask
                                                                              Definition

                                                                              A reference to a code defined by a terminology system.

                                                                              ShortCode 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.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeCoding
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Requirements

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

                                                                              Pattern Value{
                                                                                "system" : "http://fhir.de/CodeSystem/ask"
                                                                              }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              266. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.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
                                                                              268. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.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 Medication.ingredient.item[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 270. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.system
                                                                                Definition

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

                                                                                ShortIdentity 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.

                                                                                Control1..1
                                                                                Typeuri
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                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()))
                                                                                272. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.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()))
                                                                                274. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.code
                                                                                Definition

                                                                                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).

                                                                                ShortSymbol in syntax defined by the system
                                                                                Control1..1
                                                                                Typecode
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                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()))
                                                                                276. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.display
                                                                                Definition

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

                                                                                ShortRepresentation defined by the system
                                                                                Comments

                                                                                Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                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()))
                                                                                278. Medication.ingredient.item[x]:itemCodeableConcept.coding:ask.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()))
                                                                                280. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de
                                                                                Slice Nameatc-de
                                                                                Definition

                                                                                A reference to a code defined by a terminology system.

                                                                                ShortCode 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.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeCoding
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Requirements

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

                                                                                Pattern Value{
                                                                                  "system" : "http://fhir.de/CodeSystem/bfarm/atc"
                                                                                }
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                282. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.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
                                                                                284. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.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 Medication.ingredient.item[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 286. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.system
                                                                                  Definition

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

                                                                                  ShortIdentity 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.

                                                                                  Control1..1
                                                                                  Typeuri
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  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()))
                                                                                  288. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.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)
                                                                                  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()))
                                                                                  290. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.code
                                                                                  Definition

                                                                                  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).

                                                                                  ShortSymbol in syntax defined by the system
                                                                                  Control1..1
                                                                                  Typecode
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  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()))
                                                                                  292. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.display
                                                                                  Definition

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

                                                                                  ShortRepresentation defined by the system
                                                                                  Comments

                                                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  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()))
                                                                                  294. Medication.ingredient.item[x]:itemCodeableConcept.coding:atc-de.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()))
                                                                                  296. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn
                                                                                  Slice Namepzn
                                                                                  Definition

                                                                                  A reference to a code defined by a terminology system.

                                                                                  ShortCode 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.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeCoding
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

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

                                                                                  Pattern Value{
                                                                                    "system" : "http://fhir.de/CodeSystem/ifa/pzn"
                                                                                  }
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  298. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.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
                                                                                  300. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.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 Medication.ingredient.item[x].coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 302. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.system
                                                                                    Definition

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

                                                                                    ShortIdentity 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.

                                                                                    Control1..1
                                                                                    Typeuri
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    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()))
                                                                                    304. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.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()))
                                                                                    306. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.code
                                                                                    Definition

                                                                                    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).

                                                                                    ShortSymbol in syntax defined by the system
                                                                                    Control1..1
                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    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()))
                                                                                    308. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.display
                                                                                    Definition

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

                                                                                    ShortRepresentation defined by the system
                                                                                    Comments

                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    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()))
                                                                                    310. Medication.ingredient.item[x]:itemCodeableConcept.coding:pzn.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()))
                                                                                    312. Medication.ingredient.item[x]:itemCodeableConcept.text
                                                                                    Definition

                                                                                    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.

                                                                                    ShortPlain 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
                                                                                    Must Supporttrue
                                                                                    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()))
                                                                                    314. Medication.ingredient.item[x]:itemReference
                                                                                    Slice NameitemReference
                                                                                    Definition

                                                                                    The actual ingredient - either a substance (simple ingredient) or another medication of a medication.

                                                                                    ShortRestricted EPAMedicationPZNIngredient & EPAMedicationPharmaceuticalProduct only
                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeReference(Medication)
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Requirements

                                                                                    The ingredient may reference a substance (for example, amoxicillin) or another medication (for example in the case of a compounded product, Glaxal Base).

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

                                                                                    Indication of whether this ingredient affects the therapeutic action of the drug.

                                                                                    ShortIs it an active ingredient?
                                                                                    Control0..1
                                                                                    Typeboolean
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    True indicates that the ingredient affects the therapeutic action of the drug (i.e. active). False indicates that the ingredient does not affect the therapeutic action of the drug (i.e. inactive).

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

                                                                                    Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tablet.

                                                                                    ShortStrength
                                                                                    Comments

                                                                                    The Ratio datatype should only be used to express a relationship of two numbers if the relationship cannot be suitably expressed using a Quantity and a common unit. Where the denominator value is known to be fixed to "1", Quantity should be used instead of Ratio.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeRatio
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present ((numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists()))
                                                                                    320. Medication.ingredient.strength.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
                                                                                    322. Medication.ingredient.strength.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 Medication.ingredient.strength.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 324. Medication.ingredient.strength.extension:amountText
                                                                                      Slice NameamountText
                                                                                      Definition

                                                                                      Free-text amount of the ingredient for classical Latin notations such as "ad 100.0" or "quantum satis," including the unit.

                                                                                      ShortExtension
                                                                                      Control0..1
                                                                                      TypeExtension(MedicationIngredientAmountExtensions) (Extension Type: string)
                                                                                      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())
                                                                                      326. Medication.ingredient.strength.numerator
                                                                                      Definition

                                                                                      The value of the numerator.

                                                                                      ShortNumerator value
                                                                                      Comments

                                                                                      The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      BindingThe codes SHOULD be taken from UCUMCodes
                                                                                      (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                                                                                      TypeQuantity
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                      328. Medication.ingredient.strength.numerator.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
                                                                                      330. Medication.ingredient.strength.numerator.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 Medication.ingredient.strength.numerator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 332. Medication.ingredient.strength.numerator.value
                                                                                        Definition

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

                                                                                        ShortNumerical 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).

                                                                                        Control1..1
                                                                                        Typedecimal
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Must Supporttrue
                                                                                        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()))
                                                                                        334. Medication.ingredient.strength.numerator.comparator
                                                                                        Definition

                                                                                        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..1
                                                                                        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()))
                                                                                        336. Medication.ingredient.strength.numerator.unit
                                                                                        Definition

                                                                                        A human-readable form of the unit.

                                                                                        ShortUnit representation
                                                                                        Comments

                                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Must Supporttrue
                                                                                        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()))
                                                                                        338. Medication.ingredient.strength.numerator.system
                                                                                        Definition

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

                                                                                        ShortSystem that defines coded unit form
                                                                                        Comments

                                                                                        see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                        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
                                                                                        Must Supporttrue
                                                                                        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()))
                                                                                        340. Medication.ingredient.strength.numerator.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
                                                                                        Must Supporttrue
                                                                                        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()))
                                                                                        342. Medication.ingredient.strength.denominator
                                                                                        Definition

                                                                                        The value of the denominator.

                                                                                        ShortDenominator value
                                                                                        Comments

                                                                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingThe codes SHOULD be taken from UCUMCodes
                                                                                        (preferred to http://hl7.org/fhir/ValueSet/ucum-units)
                                                                                        TypeQuantity
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                        344. Medication.ingredient.strength.denominator.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
                                                                                        346. Medication.ingredient.strength.denominator.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 Medication.ingredient.strength.denominator.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 348. Medication.ingredient.strength.denominator.value
                                                                                          Definition

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

                                                                                          ShortNumerical 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).

                                                                                          Control1..1
                                                                                          Typedecimal
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          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()))
                                                                                          350. Medication.ingredient.strength.denominator.comparator
                                                                                          Definition

                                                                                          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..1
                                                                                          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()))
                                                                                          352. Medication.ingredient.strength.denominator.unit
                                                                                          Definition

                                                                                          A human-readable form of the unit.

                                                                                          ShortUnit representation
                                                                                          Comments

                                                                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Must Supporttrue
                                                                                          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()))
                                                                                          354. Medication.ingredient.strength.denominator.system
                                                                                          Definition

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

                                                                                          ShortSystem that defines coded unit form
                                                                                          Comments

                                                                                          see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                          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
                                                                                          Must Supporttrue
                                                                                          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()))
                                                                                          356. Medication.ingredient.strength.denominator.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
                                                                                          Must Supporttrue
                                                                                          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()))
                                                                                          358. Medication.batch
                                                                                          Definition

                                                                                          Information that only applies to packages (not products).

                                                                                          ShortDetails about packaged medications
                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeBackboneElement
                                                                                          Is Modifierfalse
                                                                                          Must Supporttrue
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          360. Medication.batch.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
                                                                                          362. Medication.batch.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 Medication.batch.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 364. Medication.batch.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())
                                                                                            366. Medication.batch.lotNumber
                                                                                            Definition

                                                                                            The assigned lot number of a batch of the specified product.

                                                                                            ShortIdentifier assigned to batch
                                                                                            Comments

                                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Must Supporttrue
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            368. Medication.batch.expirationDate
                                                                                            Definition

                                                                                            When this specific batch of product will expire.

                                                                                            ShortWhen batch will expire
                                                                                            Control0..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()))