PrescribeIT® Specification and Guide Version 5.0

 

XML representation of the ext-medicationorder-dispense-first-fill Extension



<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="ext-medicationorder-dispense-first-fill"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/2016may/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension" title="Provides specific instructions as to how the first fill of a prescription should be dispensed.

Usage Note: This is typically provided when the prescriber wants the patient to try a medication for short period of time in order to determine if the patient can tolerate the medication without issues or to determine whether the medication is effective prior to the patient receiving a larger supply that would be wasted if not tolerated or not effective. The first fill information should only be specified in the case of additional refills, where the quantity or expected supply duration of the refills differs from the first fill. If the first fill information is not provided, it means that the general dispenseRequest instructions related to the quantity or expected supply duration apply to all fills.">Extension</a><a name="Extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span>..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">First fill instructions</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck12.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension">extension</a><a name="Extension.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span>..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Extension</span><br/><span style="font-weight:bold">Slice: </span>Unordered, Open by value:url<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck15.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:date" title="Slice date: Indicates the date by which the initial fill of the prescription must be made.  If not dispensed on or before this date, no subsequent fills are permitted.">extension:date</a><a name="Extension.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span>..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Date to make first fill by</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:date.url">url</a><a name="Extension.extension.url"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/2016may/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="color: darkgreen">&quot;expiry&quot;</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck140.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:date.value[x]" title="First fill expiry date value.">value[x]</a><a name="Extension.extension.value_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span><span style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element has or is affected by some invariants (expiry-full)">I</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/datatypes.html#date">date</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Value of extension</span><br/><span style="font-weight:bold">expiry-full: </span>Must be at least a full date.  i.e. yyyy-mm-dd</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck15.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:quantity" title="Slice quantity: Indicates the quantity that should be provided as part of the first dispense that is done against the prescription.">extension:quantity</a><a name="Extension.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span>..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Amount of initial fill</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:quantity.url">url</a><a name="Extension.extension.url"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/2016may/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="color: darkgreen">&quot;quantity&quot;</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck140.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:quantity.value[x]">value[x]</a><a name="Extension.extension.value_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="dtprofile-quantity-drug.html" title="Quantity">PrescribeIT® Drug Quantity</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Quantity of a medication</span><br/><span style="font-weight:bold">Binding: </span><a href="https://tgateway.infoway-inforoute.ca/vs/prescribedquantityunit?versionid=20220331">PrescribedQuantityUnit (20220331)</a> (<a href="http://hl7.org/fhir/2016may/terminologies.html#extensible" title="To be conformant, the concept in this element SHALL be from the specified value set if any of the codes within the value set can apply to the concept being communicated.  If the value set does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">extensible</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck15.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:expectedSupplyDuration" title="Slice expectedSupplyDuration: Indicates the number of days supply of the medication that should be provided as part of the first dispense that is done against the prescription.">extension:expectedSupplyDuration</a><a name="Extension.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span>..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Days supply for initial fill</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck150.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:expectedSupplyDuration.url">url</a><a name="Extension.extension.url"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/2016may/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="color: darkgreen">&quot;expectedSupplyDuration&quot;</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck140.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.extension:expectedSupplyDuration.value[x]">value[x]</a><a name="Extension.extension.value_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/2016may/datatypes.html#Duration" title="Quantity">Duration</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">A length of time</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="extension-ext-medicationorder-dispense-first-fill-definitions.html#Extension.url">url</a><a name="Extension.url"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/2016may/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="color: darkgreen">&quot;http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill&quot;</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <span style="text-decoration:line-through">value[x]</span><a name="Extension.value_x_"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="text-decoration:line-through"/><span style="text-decoration:line-through">0</span><span style="text-decoration:line-through">..</span><span style="text-decoration:line-through">0</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/2016may/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/2016may/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill"/>
  <version value="5.0"/>
  <name value="Medication Order Dispense First Fill Instructions"/>
  <status value="draft"/>
  <date value="2016-03-30T17:01:25-04:00"/>
  <description
               value="Provides instructions specific to how the first fill of a prescription should be processed (if different from other fills)"/>
  <requirements
                value="The ability to add extensions in a structured way is what keeps FHIR resources simple."/>
  <fhirVersion value="1.4.0"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM"/>
  </mapping>
  <kind value="datatype"/>
  <abstract value="false"/>
  <contextType value="resource"/>
  <context value="MedicationOrder.dispenseRequest"/>
  <baseType value="Extension"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Extension">
      <path value="Extension"/>
      <short value="First fill instructions"/>
      <definition
                  value="Provides specific instructions as to how the first fill of a prescription should be dispensed.

Usage Note: This is typically provided when the prescriber wants the patient to try a medication for short period of time in order to determine if the patient can tolerate the medication without issues or to determine whether the medication is effective prior to the patient receiving a larger supply that would be wasted if not tolerated or not effective. The first fill information should only be specified in the case of additional refills, where the quantity or expected supply duration of the refills differs from the first fill. If the first fill information is not provided, it means that the general dispenseRequest instructions related to the quantity or expected supply duration apply to all fills."/>
      <comments
                value="Conformance Rule: If entry of the first fill information is supported within the EMR as discrete information, this must be populated. For the first fill instructions to be meaningful, the first fill quantity or the first fill expected supply duration must be provided. Both can be provided if available but at minimum one of these must be provided."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Extension.id">
      <path value="Extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Extension.extension:date">
      <path value="Extension.extension"/>
      <name value="date"/>
      <short value="Date to make first fill by"/>
      <definition
                  value="Indicates the date by which the initial fill of the prescription must be made.  If not dispensed on or before this date, no subsequent fills are permitted."/>
      <comments
                value="Conformance Rules: If the first fill expiry date concept is supported within the EMR as a discrete data element, this must be populated."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Extension.extension:date.id">
      <path value="Extension.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Extension.extension:date.extension">
      <path value="Extension.extension.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Extension.extension:date.url">
      <path value="Extension.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comments value="Fixed value: expiry"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="expiry"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Extension.extension:date.value[x]">
      <path value="Extension.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition value="First fill expiry date value."/>
      <comments value="Conformance Rule: Must be a full date value."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <constraint>
        <key value="expiry-full"/>
        <severity value="error"/>
        <human value="Must be at least a full date.  i.e. yyyy-mm-dd"/>
        <expression value="length()&gt;=10"/>
        <xpath value="string-length(@value) &gt;= 10)"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Extension.extension:quantity">
      <path value="Extension.extension"/>
      <name value="quantity"/>
      <short value="Amount of initial fill"/>
      <definition
                  value="Indicates the quantity that should be provided as part of the first dispense that is done against the prescription."/>
      <comments
                value="Conformance Rule: The first fill quantity or the first fill expected supply duration must be provided. Both can be provided if available but at minimum one of these needs to be provided."/>
      <requirements
                    value="Allows a more limited quantity to be dispensed on the initial dispense to confirm the medication is tolerated and providing the desired effect before incurring the costs of a full fill."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Extension.extension:quantity.id">
      <path value="Extension.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Extension.extension:quantity.extension">
      <path value="Extension.extension.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Extension.extension:quantity.url">
      <path value="Extension.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comments value="Fixed value: quantity"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="quantity"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Extension.extension:quantity.value[x]">
      <path value="Extension.extension.value[x]"/>
      <short value="Quantity of a medication"/>
      <definition
                  value="A measured or counted amount of a medication expressed as a value and human-readable string with optional coded units expressed in a local coding system"/>
      <comments
                value="Usage Note: Quantity is used throughout the messages. It may be a drug form (e.g. TAB) an administrable drug (e.g. PUFF) form or a unit of measure (e.g. mg)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://prescribeit.ca/fhir/StructureDefinition/dtprofile-quantity-drug"/>
      </type>
      <maxLength value="0"/>
      <constraint>
        <key value="qty-3"/>
        <severity value="error"/>
        <human
               value="If a code for the unit is present, the system SHALL also be present"/>
        <expression value="code.empty() or system.exists()"/>
        <xpath value="not(exists(f:code)) or exists(f:system)"/>
      </constraint>
      <constraint>
        <key value="sqty-1"/>
        <severity value="error"/>
        <human value="The comparator is not used on a SimpleQuantity"/>
        <expression value="comparator.empty()"/>
        <xpath value="not(exists(f:comparator))"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="https://fhir.infoway-inforoute.ca/ValueSet/prescribedquantityunit|20220331"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="SN (see also Range) or CQ"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values"/>
      </mapping>
    </element>
    <element id="Extension.extension:expectedSupplyDuration">
      <path value="Extension.extension"/>
      <name value="expectedSupplyDuration"/>
      <short value="Days supply for initial fill"/>
      <definition
                  value="Indicates the number of days supply of the medication that should be provided as part of the first dispense that is done against the prescription."/>
      <comments
                value="Conformance Rules: The first fill quantity or the first fill expected supply duration must be provided. Both can be provided if available but at minimum one of these needs to be provided.

Conformance Rule: When providing the first fill expected supply duration it must be expressed as a duration of time in days&#39;."/>
      <requirements
                    value="Allows a more limited quantity to be dispensed on the initial dispense to confirm the medication is tolerated and providing the desired effect before incurring the costs of a full fill."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Extension.extension:expectedSupplyDuration.id">
      <path value="Extension.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Extension.extension:expectedSupplyDuration.extension">
      <path value="Extension.extension.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Extension.extension:expectedSupplyDuration.url">
      <path value="Extension.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comments value="Fixed value: expectedSupplyDuration"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="expectedSupplyDuration"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Extension.extension:expectedSupplyDuration.value[x]">
      <path value="Extension.extension.value[x]"/>
      <short value="A length of time"/>
      <definition
                  value="There SHALL be a code if there is a value and it SHALL be an expression of time.  If system is present, it SHALL be UCUM."/>
      <comments
                value="Conformance Rule: The duration must be expressed as a ‘day(s)’ value and must be coded in the following way; code must be &#39;d&#39; and system must be &#39;http://unitsofmeasure.org&#39;."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Duration"/>
      </type>
      <maxLength value="0"/>
      <constraint>
        <key value="qty-3"/>
        <severity value="error"/>
        <human
               value="If a code for the unit is present, the system SHALL also be present"/>
        <expression value="code.empty() or system.exists()"/>
        <xpath value="not(exists(f:code)) or exists(f:system)"/>
      </constraint>
      <constraint>
        <key value="drt-1"/>
        <severity value="error"/>
        <human
               value="There SHALL be a code if there is a value and it SHALL be an expression of time.  If system is present, it SHALL be UCUM."/>
        <expression
                    value="(code.exists() or value.empty()) and (system.empty() or system = %ucum)"/>
        <xpath
               value="(f:code or not(f:value)) and (not(exists(f:system)) or f:system/@value=&#39;http://unitsofmeasure.org&#39;)"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="SN (see also Range) or CQ"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="PQ, IVL&lt;PQ&gt;, MO, CO, depending on the values"/>
      </mapping>
    </element>
    <element id="Extension.url">
      <path value="Extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comments
                value="Fixed value: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri
                value="http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="integer"/>
      </type>
      <type>
        <code value="decimal"/>
      </type>
      <type>
        <code value="base64Binary"/>
      </type>
      <type>
        <code value="instant"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="uri"/>
      </type>
      <type>
        <code value="date"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="code"/>
      </type>
      <type>
        <code value="oid"/>
      </type>
      <type>
        <code value="id"/>
      </type>
      <type>
        <code value="unsignedInt"/>
      </type>
      <type>
        <code value="positiveInt"/>
      </type>
      <type>
        <code value="markdown"/>
      </type>
      <type>
        <code value="Annotation"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="Identifier"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Coding"/>
      </type>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Signature"/>
      </type>
      <type>
        <code value="HumanName"/>
      </type>
      <type>
        <code value="Address"/>
      </type>
      <type>
        <code value="ContactPoint"/>
      </type>
      <type>
        <code value="Timing"/>
      </type>
      <type>
        <code value="Reference"/>
      </type>
      <type>
        <code value="Meta"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Extension">
      <path value="Extension"/>
      <short value="First fill instructions"/>
      <definition
                  value="Provides specific instructions as to how the first fill of a prescription should be dispensed.

Usage Note: This is typically provided when the prescriber wants the patient to try a medication for short period of time in order to determine if the patient can tolerate the medication without issues or to determine whether the medication is effective prior to the patient receiving a larger supply that would be wasted if not tolerated or not effective. The first fill information should only be specified in the case of additional refills, where the quantity or expected supply duration of the refills differs from the first fill. If the first fill information is not provided, it means that the general dispenseRequest instructions related to the quantity or expected supply duration apply to all fills."/>
      <comments
                value="Conformance Rule: If entry of the first fill information is supported within the EMR as discrete information, this must be populated. For the first fill instructions to be meaningful, the first fill quantity or the first fill expected supply duration must be provided. Both can be provided if available but at minimum one of these must be provided."/>
      <max value="1"/>
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:date">
      <path value="Extension.extension"/>
      <name value="date"/>
      <short value="Date to make first fill by"/>
      <definition
                  value="Indicates the date by which the initial fill of the prescription must be made.  If not dispensed on or before this date, no subsequent fills are permitted."/>
      <comments
                value="Conformance Rules: If the first fill expiry date concept is supported within the EMR as a discrete data element, this must be populated."/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:date.url">
      <path value="Extension.extension.url"/>
      <comments value="Fixed value: expiry"/>
      <min value="1"/>
      <fixedUri value="expiry"/>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:date.value[x]">
      <path value="Extension.extension.value[x]"/>
      <definition value="First fill expiry date value."/>
      <comments value="Conformance Rule: Must be a full date value."/>
      <min value="1"/>
      <type>
        <code value="date"/>
      </type>
      <constraint>
        <key value="expiry-full"/>
        <severity value="error"/>
        <human value="Must be at least a full date.  i.e. yyyy-mm-dd"/>
        <expression value="length()&gt;=10"/>
        <xpath value="string-length(@value) &gt;= 10)"/>
      </constraint>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:quantity">
      <path value="Extension.extension"/>
      <name value="quantity"/>
      <short value="Amount of initial fill"/>
      <definition
                  value="Indicates the quantity that should be provided as part of the first dispense that is done against the prescription."/>
      <comments
                value="Conformance Rule: The first fill quantity or the first fill expected supply duration must be provided. Both can be provided if available but at minimum one of these needs to be provided."/>
      <requirements
                    value="Allows a more limited quantity to be dispensed on the initial dispense to confirm the medication is tolerated and providing the desired effect before incurring the costs of a full fill."/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:quantity.url">
      <path value="Extension.extension.url"/>
      <comments value="Fixed value: quantity"/>
      <min value="1"/>
      <fixedUri value="quantity"/>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:quantity.value[x]">
      <path value="Extension.extension.value[x]"/>
      <min value="1"/>
      <type>
        <code value="Quantity"/>
        <profile
                 value="http://prescribeit.ca/fhir/StructureDefinition/dtprofile-quantity-drug"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="https://fhir.infoway-inforoute.ca/ValueSet/prescribedquantityunit|20220331"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Extension.extension:expectedSupplyDuration">
      <path value="Extension.extension"/>
      <name value="expectedSupplyDuration"/>
      <short value="Days supply for initial fill"/>
      <definition
                  value="Indicates the number of days supply of the medication that should be provided as part of the first dispense that is done against the prescription."/>
      <comments
                value="Conformance Rules: The first fill quantity or the first fill expected supply duration must be provided. Both can be provided if available but at minimum one of these needs to be provided.

Conformance Rule: When providing the first fill expected supply duration it must be expressed as a duration of time in days&#39;."/>
      <requirements
                    value="Allows a more limited quantity to be dispensed on the initial dispense to confirm the medication is tolerated and providing the desired effect before incurring the costs of a full fill."/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:expectedSupplyDuration.url">
      <path value="Extension.extension.url"/>
      <comments value="Fixed value: expectedSupplyDuration"/>
      <min value="1"/>
      <fixedUri value="expectedSupplyDuration"/>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.extension:expectedSupplyDuration.value[x]">
      <path value="Extension.extension.value[x]"/>
      <comments
                value="Conformance Rule: The duration must be expressed as a ‘day(s)’ value and must be coded in the following way; code must be &#39;d&#39; and system must be &#39;http://unitsofmeasure.org&#39;."/>
      <min value="1"/>
      <type>
        <code value="Quantity"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Duration"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.url">
      <path value="Extension.url"/>
      <comments
                value="Fixed value: http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill"/>
      <min value="1"/>
      <fixedUri
                value="http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dispense-first-fill"/>
      <mustSupport value="true"/>
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]"/>
      <max value="0"/>
      <mustSupport value="false"/>
    </element>
  </differential>
</StructureDefinition>