Medication IG DE
1.0.0-ballot - STU1

This page is part of the Medication IG DE (v1.0.0-ballot: STU1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Data Type Profile: DosageDgMP - Detailed Descriptions

Draft as of 2025-07-22

Definitions for the DosageDgMP data type profile.

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

0. Dosage
Definition

Indicates how the medication is/was taken or should be taken by the patient.

ShortHow the medication is/was taken or should be taken
Control0..*
This element is affected by the following invariants: ele-1
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies timing.exists()) ) )
DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies %resource.dosageInstruction.doseAndRate.dose.ofType(Quantity).code.distinct().count() = 1 ))
DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
2. Dosage.extension:generatedDosageInstructions
Slice NamegeneratedDosageInstructions
Definition

Diese Extension enthält die automatisch generierte textuelle Dosierungsanweisung, die auf Basis der bereitgestellten strukturierten Dosierungsinformationen erstellt wurde.

ShortGenerated Dosage Instructions
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Generated Dosage Instructions) (Complex Extension)
Must Supporttrue
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())
4. Dosage.extension:generatedDosageInstructions.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.

Control40..*
This element is affected by the following invariants: ele-1
TypeExtension
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 Dosage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Dosage.extension:generatedDosageInstructions.extension:text
    Slice Nametext
    Definition

    An Extension

    ShortExtensionAdditional content defined by implementations
    Control10..1*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Must Supporttrue
    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())
    8. Dosage.extension:generatedDosageInstructions.extension:text.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
    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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. Dosage.extension:generatedDosageInstructions.extension:text.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 Valuetext
      12. Dosage.extension:generatedDosageInstructions.extension:text.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
      Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 14. Dosage.extension:generatedDosageInstructions.extension:text.value[x]:valueString
        Slice NamevalueString
        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
        Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        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()))
        16. Dosage.extension:generatedDosageInstructions.extension:language
        Slice Namelanguage
        Definition

        An Extension

        ShortExtensionAdditional content defined by implementations
        Control10..1*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Must Supporttrue
        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())
        18. Dosage.extension:generatedDosageInstructions.extension:language.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
        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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 20. Dosage.extension:generatedDosageInstructions.extension:language.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 Valuelanguage
          22. Dosage.extension:generatedDosageInstructions.extension:language.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
          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]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 24. Dosage.extension:generatedDosageInstructions.extension:language.value[x]:valueCode
            Slice NamevalueCode
            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 Algorithm Language Codes dgMP ValueSet
            (required to http://ig.fhir.de/igs/medication/ValueSet/AlgorithmLanguageCodesDgMP)
            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]
            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()))
            26. Dosage.extension:generatedDosageInstructions.extension:algorithm
            Slice Namealgorithm
            Definition

            An Extension

            ShortExtensionAdditional content defined by implementations
            Control10..1*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            28. Dosage.extension:generatedDosageInstructions.extension:algorithm.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
            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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 30. Dosage.extension:generatedDosageInstructions.extension:algorithm.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 Valuealgorithm
              32. Dosage.extension:generatedDosageInstructions.extension:algorithm.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
              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]
              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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
              • type @ $this
              • 34. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding
                Slice NamevalueCoding
                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
                BindingUnless not suitable, these codes SHALL be taken from For codes, see Dosage Text Algorithm ValueSet
                (extensible to http://ig.fhir.de/igs/medication/ValueSet/DosageTextAlgorithm)
                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]
                Must Supporttrue
                Pattern Value{
                  "system" : "http://ig.fhir.de/igs/medication/CodeSystem/DosageTextAlgorithm",
                  "code" : "GematikDosageTextGenerator"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                This element is affected by the following invariants: ele-1
                Typeuri
                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()))
                38. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                This element is affected by the following invariants: ele-1
                Typestring
                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()))
                40. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control10..1
                This element is affected by the following invariants: ele-1
                Typecode
                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()))
                42. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion
                Slice NamealgorithmVersion
                Definition

                An Extension

                ShortExtensionAdditional content defined by implementations
                Control10..1*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Must Supporttrue
                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())
                44. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.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
                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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 46. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.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 ValuealgorithmVersion
                  48. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.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
                  Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 50. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.value[x]:valueString
                    Slice NamevalueString
                    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
                    Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    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()))
                    52. Dosage.extension:generatedDosageInstructions.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://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructions
                    54. Dosage.extension:generatedDosageInstructions.value[x]
                    Definition

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

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

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

                    ShortThe order of the dosage instructions
                    Comments

                    Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                    32 bit number; for values larger than this, use decimal

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    Typeinteger
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

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

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

                    Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Tablette bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker


                    Free text dosage instructions e.g. SIG.

                    ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Tablette bei Bedarf'Free text dosage instructions e.g. SIG
                    Comments

                    Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.


                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

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

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

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

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

                    Control0..0*
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see SNOMEDCTAdditionalDosageInstructionshttp://hl7.org/fhir/ValueSet/additional-instruction-codes
                    (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

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

                    TypeCodeableConcept
                    Summarytrue
                    Requirements

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

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

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

                    ShortPatient or consumer oriented instructions
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    Typestring
                    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()))
                    66. Dosage.timing
                    Definition

                    Wann das Medikament verabreicht werden soll.


                    When medication should be administered.

                    ShortWann das Medikament verabreicht werden sollWhen medication should be administered
                    Comments

                    Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructions Extension zu verwenden.


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

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeTiming(Timing dgMP)
                    Must Supporttrue
                    Summarytrue
                    Requirements

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

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. Dosage.asNeeded[x]
                    Definition

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

                    ShortTake "as needed" (for x)
                    Comments

                    Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodeshttp://hl7.org/fhir/ValueSet/medication-as-needed-reason
                    (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

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

                    TypeChoice of: boolean, CodeableConcept
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    70. Dosage.site
                    Definition

                    Body site to administer to.

                    ShortBody site to administer to
                    Comments

                    Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodeshttp://hl7.org/fhir/ValueSet/approach-site-codes
                    (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

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

                    TypeCodeableConcept
                    Summarytrue
                    Requirements

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

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

                    How drug should enter body.

                    ShortHow drug should enter body
                    Comments

                    Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes
                    (example to http://hl7.org/fhir/ValueSet/route-codes)

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

                    TypeCodeableConcept
                    Summarytrue
                    Requirements

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

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

                    Technique for administering medication.

                    ShortTechnique for administering medication
                    Comments

                    Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see SNOMEDCTAdministrationMethodCodeshttp://hl7.org/fhir/ValueSet/administration-method-codes
                    (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

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

                    TypeCodeableConcept
                    Summarytrue
                    Requirements

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

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

                    Die verabreichte Menge des Medikaments.


                    The amount of medication administered.

                    ShortMenge des verabreichten MedikamentsAmount of medication administered
                    Comments

                    Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                    Control0..1*
                    This element is affected by the following invariants: ele-1
                    TypeElement
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. Dosage.doseAndRate.type
                    Definition

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

                    ShortThe kind of dose or rate specified
                    Comments

                    Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                    Control0..01
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see DoseAndRateTypehttp://hl7.org/fhir/ValueSet/dose-rate-type
                    (example to http://hl7.org/fhir/ValueSet/dose-rate-type)

                    The kind of dose or rate specified.

                    TypeCodeableConcept
                    Summarytrue
                    Requirements

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

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

                    Amount of medication per dose.

                    ShortAmount of medication per dose
                    Comments

                    Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeQuantity(SimpleQuantity), Range
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Summarytrue
                    Requirements

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

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

                      Menge des Medikaments pro Dosis.


                      Amount of medication per dose.

                      ShortMenge des Medikaments pro DosisAmount of medication per dose
                      Comments

                      Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.


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

                      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_BMP_DOSIEREINHEIT
                      (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                      TypeQuantity(SimpleQuantity), Range
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Must Supporttrue
                      Summarytrue
                      Requirements

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

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

                      Not allowed to be used in this context


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

                      Short< | <= | >= | > - how to understand the value
                      Comments

                      Note that FHIR strings SHALL NOT exceed 1MB in size

                      Control0..01
                      This element is affected by the following invariants: ele-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()))
                      86. Dosage.doseAndRate.dose[x]:doseQuantity.unit
                      Definition

                      A human-readable form of the unit.

                      ShortUnit representation
                      Comments

                      Note that FHIR strings SHALL NOT exceed 1MB in size

                      Control10..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      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()))
                      88. Dosage.doseAndRate.dose[x]:doseQuantity.system
                      Definition

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

                      ShortSystem that defines coded unit form
                      Comments

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

                      Control10..1
                      This element is affected by the following invariants: ele-1, qty-3
                      Typeuri
                      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()))
                      90. Dosage.doseAndRate.dose[x]:doseQuantity.code
                      Definition

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

                      ShortCoded form of the unit
                      Comments

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

                      Control10..1
                      This element is affected by the following invariants: ele-1
                      Typecode
                      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()))
                      92. Dosage.doseAndRate.rate[x]
                      Definition

                      Amount of medication per unit of time.

                      ShortAmount of medication per unit of time
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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

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

                      Control0..01
                      This element is affected by the following invariants: ele-1
                      TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                      Summarytrue
                      Requirements

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

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

                      Upper limit on medication per unit of time.

                      ShortUpper limit on medication per unit of time
                      Comments

                      Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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

                      Control0..01
                      This element is affected by the following invariants: ele-1
                      TypeRatio
                      Summarytrue
                      Requirements

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

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

                      Upper limit on medication per administration.

                      ShortUpper limit on medication per administration
                      Comments

                      Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


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

                      Control0..01
                      This element is affected by the following invariants: ele-1
                      TypeQuantity(SimpleQuantity)
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                      sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                      98. Dosage.maxDosePerLifetime
                      Definition

                      Upper limit on medication per lifetime of the patient.

                      ShortUpper limit on medication per lifetime of the patient
                      Comments

                      Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.


                      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..01
                      This element is affected by the following invariants: ele-1
                      TypeQuantity(SimpleQuantity)
                      Is Modifierfalse
                      Summarytrue
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                      sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())

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

                      0. Dosage
                      InvariantsDosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
                      2. Dosage.extension:generatedDosageInstructions
                      Slice NamegeneratedDosageInstructions
                      4. Dosage.extension:generatedDosageInstructions.extension
                      Control4..?
                      6. Dosage.extension:generatedDosageInstructions.extension:language
                      Slice Namelanguage
                      Control1..?
                      8. Dosage.extension:generatedDosageInstructions.extension:language.value[x]:valueCode
                      Slice NamevalueCode
                      BindingThe codes SHALL be taken from Algorithm Language Codes dgMP ValueSet
                      (required to http://ig.fhir.de/igs/medication/ValueSet/AlgorithmLanguageCodesDgMP)
                      Typecode
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      10. Dosage.extension:generatedDosageInstructions.extension:algorithm
                      Slice Namealgorithm
                      Control1..?
                      12. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding
                      Slice NamevalueCoding
                      TypeCoding
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Pattern Value{
                        "system" : "http://ig.fhir.de/igs/medication/CodeSystem/DosageTextAlgorithm",
                        "code" : "GematikDosageTextGenerator"
                      }
                      14. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion
                      Slice NamealgorithmVersion
                      Control1..?
                      16. Dosage.sequence
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      18. Dosage.additionalInstruction
                      Control0..0
                      20. Dosage.patientInstruction
                      Control0..0
                      22. Dosage.timing
                      TypeTiming(Timing dgMP)
                      24. Dosage.asNeeded[x]
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      26. Dosage.site
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      28. Dosage.route
                      Comments

                      Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      30. Dosage.method
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      32. Dosage.doseAndRate
                      Comments

                      Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..1
                      34. Dosage.doseAndRate.type
                      Comments

                      Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      36. Dosage.doseAndRate.dose[x]
                      Comments

                      Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      TypeQuantity(SimpleQuantity), Range
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      38. Dosage.doseAndRate.dose[x]:doseQuantity
                      Slice NamedoseQuantity
                      BindingThe codes SHALL be taken from https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT
                      (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                      TypeQuantity(SimpleQuantity)
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      40. Dosage.doseAndRate.dose[x]:doseQuantity.unit
                      Control1..?
                      Must Supporttrue
                      42. Dosage.doseAndRate.dose[x]:doseQuantity.system
                      Control1..?
                      Must Supporttrue
                      44. Dosage.doseAndRate.dose[x]:doseQuantity.code
                      Control1..?
                      Must Supporttrue
                      46. Dosage.doseAndRate.rate[x]
                      Comments

                      Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      48. Dosage.maxDosePerPeriod
                      Comments

                      Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      50. Dosage.maxDosePerAdministration
                      Comments

                      Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0
                      52. Dosage.maxDosePerLifetime
                      Comments

                      Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                      Control0..0

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

                      0. Dosage
                      Definition

                      Indicates how the medication is/was taken or should be taken by the patient.

                      ShortHow the medication is/was taken or should be taken
                      Control0..*
                      This element is affected by the following invariants: ele-1
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      DosageStructuredOrFreeTextWarning: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
                      DosageStructuredRequiresBoth: Wenn eine strukturierte Dosierungsangabe erfolgt, müssen sowohl timing als auch doseAndRate angegeben werden. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (timing.exists() implies doseAndRate.exists()) and (doseAndRate.exists() implies timing.exists()) ) )
                      DosageDoseUnitSameCode: Die Dosiereinheit muss über alle Dosierungen gleich sein. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( doseAndRate.exists() implies %resource.dosageInstruction.doseAndRate.dose.ofType(Quantity).code.distinct().count() = 1 ))
                      DosageStructuredOrFreeText: Die Dosierungsangabe darf entweder nur als Freitext oder nur als vollständige strukturierte Information erfolgen — eine Mischung ist nicht erlaubt. ((%resource.ofType(MedicationRequest).dosageInstruction | ofType(MedicationDispense).dosageInstruction | ofType(MedicationStatement).dosage).all( (text.exists() and timing.empty() and doseAndRate.empty()) or (text.empty() and (timing.exists() or doseAndRate.exists())) ) )
                      2. Dosage.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
                      XML FormatIn the XML format, this property is represented as an attribute.
                      4. Dosage.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..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Standard StatusNormative (from Trial Use)
                      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 Dosage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 6. Dosage.extension:generatedDosageInstructions
                        Slice NamegeneratedDosageInstructions
                        Definition

                        Diese Extension enthält die automatisch generierte textuelle Dosierungsanweisung, die auf Basis der bereitgestellten strukturierten Dosierungsinformationen erstellt wurde.

                        ShortGenerated Dosage Instructions
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Generated Dosage Instructions) (Complex Extension)
                        Must Supporttrue
                        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())
                        8. Dosage.extension:generatedDosageInstructions.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
                        XML FormatIn the XML format, this property is represented as an attribute.
                        10. Dosage.extension:generatedDosageInstructions.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control4..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        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 Dosage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 12. Dosage.extension:generatedDosageInstructions.extension:text
                          Slice Nametext
                          Definition

                          An Extension

                          ShortExtension
                          Control1..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Must Supporttrue
                          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())
                          14. Dosage.extension:generatedDosageInstructions.extension:text.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
                          XML FormatIn the XML format, this property is represented as an attribute.
                          16. Dosage.extension:generatedDosageInstructions.extension:text.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..0
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 18. Dosage.extension:generatedDosageInstructions.extension:text.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 Valuetext
                            20. Dosage.extension:generatedDosageInstructions.extension:text.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
                            Typestring
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                            • type @ $this
                            • 22. Dosage.extension:generatedDosageInstructions.extension:text.value[x]:valueString
                              Slice NamevalueString
                              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
                              Typestring
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              24. Dosage.extension:generatedDosageInstructions.extension:language
                              Slice Namelanguage
                              Definition

                              An Extension

                              ShortExtension
                              Control1..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Must Supporttrue
                              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())
                              26. Dosage.extension:generatedDosageInstructions.extension:language.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
                              XML FormatIn the XML format, this property is represented as an attribute.
                              28. Dosage.extension:generatedDosageInstructions.extension:language.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..0
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 30. Dosage.extension:generatedDosageInstructions.extension:language.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 Valuelanguage
                                32. Dosage.extension:generatedDosageInstructions.extension:language.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
                                Typecode
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 34. Dosage.extension:generatedDosageInstructions.extension:language.value[x]:valueCode
                                  Slice NamevalueCode
                                  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 Algorithm Language Codes dgMP ValueSet
                                  (required to http://ig.fhir.de/igs/medication/ValueSet/AlgorithmLanguageCodesDgMP)
                                  Typecode
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  36. Dosage.extension:generatedDosageInstructions.extension:algorithm
                                  Slice Namealgorithm
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Must Supporttrue
                                  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. Dosage.extension:generatedDosageInstructions.extension:algorithm.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
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  40. Dosage.extension:generatedDosageInstructions.extension:algorithm.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..0
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 42. Dosage.extension:generatedDosageInstructions.extension:algorithm.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 Valuealgorithm
                                    44. Dosage.extension:generatedDosageInstructions.extension:algorithm.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
                                    TypeCoding
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 46. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding
                                      Slice NamevalueCoding
                                      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
                                      BindingUnless not suitable, these codes SHALL be taken from Dosage Text Algorithm ValueSet
                                      (extensible to http://ig.fhir.de/igs/medication/ValueSet/DosageTextAlgorithm)
                                      TypeCoding
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Must Supporttrue
                                      Pattern Value{
                                        "system" : "http://ig.fhir.de/igs/medication/CodeSystem/DosageTextAlgorithm",
                                        "code" : "GematikDosageTextGenerator"
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      48. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      50. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Standard StatusNormative (from Trial Use)
                                      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 Dosage.extension.extension.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 52. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                                        This element is affected by the following invariants: ele-1
                                        Typeuri
                                        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. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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()))
                                        56. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        Typecode
                                        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. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        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. Dosage.extension:generatedDosageInstructions.extension:algorithm.value[x]:valueCoding.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
                                        This element is affected by the following invariants: ele-1
                                        Typeboolean
                                        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. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion
                                        Slice NamealgorithmVersion
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control1..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension
                                        Must Supporttrue
                                        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. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.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
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        66. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..0
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension
                                        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 Dosage.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 68. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.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 ValuealgorithmVersion
                                          70. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.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
                                          Typestring
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          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 Dosage.extension.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                          • type @ $this
                                          • 72. Dosage.extension:generatedDosageInstructions.extension:algorithmVersion.value[x]:valueString
                                            Slice NamevalueString
                                            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
                                            Typestring
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            74. Dosage.extension:generatedDosageInstructions.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://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructions
                                            76. Dosage.extension:generatedDosageInstructions.value[x]
                                            Definition

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

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

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

                                            ShortThe order of the dosage instructions
                                            Comments

                                            Begründung Einschränkung Kardinalität: Eine Dosier-Sequenz ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                            Control0..0
                                            This element is affected by the following invariants: ele-1
                                            Typeinteger
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

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

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

                                            Freitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Tablette bei Bedarf'. Als Quelle dient hier ausschließlich der Arzt oder Apotheker

                                            ShortFreitext-Dosierungsanweisungen, z. B. 'Maximal 3x täglich 1 Tablette bei Bedarf'
                                            Comments

                                            Die Freitextdosierung sollte nur angegeben werden, wenn aufgrund der Komplexität keine strukturierte Dosierung möglich ist, um widersprüchliche Anweisungen zu vermeiden.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

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

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

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

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

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

                                            Control0..0
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see SNOMEDCTAdditionalDosageInstructions
                                            (example to http://hl7.org/fhir/ValueSet/additional-instruction-codes)

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

                                            TypeCodeableConcept
                                            Summarytrue
                                            Requirements

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

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

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

                                            ShortPatient or consumer oriented instructions
                                            Comments

                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                            Control0..0
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            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()))
                                            88. Dosage.timing
                                            Definition

                                            Wann das Medikament verabreicht werden soll.

                                            ShortWann das Medikament verabreicht werden soll
                                            Comments

                                            Um widersprüchliche Anweisungen zu vermeiden, ist entweder Dosage.timing oder Dosage.text zu befüllen. Falls eine strukturierte Dosierung als Text abgebildet werden soll ist dafür die GeneratedDosageInstructions Extension zu verwenden.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeTiming(Timing dgMP)
                                            Must Supporttrue
                                            Summarytrue
                                            Requirements

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

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            90. Dosage.asNeeded[x]
                                            Definition

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

                                            ShortTake "as needed" (for x)
                                            Comments

                                            Begründung Einschränkung Kardinalität: Eine Bedarfsdosis ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                            Control0..0
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                                            (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

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

                                            TypeChoice of: boolean, CodeableConcept
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            92. Dosage.site
                                            Definition

                                            Body site to administer to.

                                            ShortBody site to administer to
                                            Comments

                                            Begründung Einschränkung Kardinalität: Eine Verabreichungsstelle ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                            Control0..0
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
                                            (example to http://hl7.org/fhir/ValueSet/approach-site-codes)

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

                                            TypeCodeableConcept
                                            Summarytrue
                                            Requirements

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

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

                                            How drug should enter body.

                                            ShortHow drug should enter body
                                            Comments

                                            Begründung Einschränkung Kardinalität: Ein Verabreichungsweg ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                            Control0..0
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see SNOMEDCTRouteCodes
                                            (example to http://hl7.org/fhir/ValueSet/route-codes)

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

                                            TypeCodeableConcept
                                            Summarytrue
                                            Requirements

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

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

                                            Technique for administering medication.

                                            ShortTechnique for administering medication
                                            Comments

                                            Begründung Einschränkung Kardinalität: Eine Verabreichungsmethode ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                            Control0..0
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see SNOMEDCTAdministrationMethodCodes
                                            (example to http://hl7.org/fhir/ValueSet/administration-method-codes)

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

                                            TypeCodeableConcept
                                            Summarytrue
                                            Requirements

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

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

                                            Die verabreichte Menge des Medikaments.

                                            ShortMenge des verabreichten Medikaments
                                            Comments

                                            Begründung Einschränkung Kardinalität: Nur eine Dosierung pro Medikation ist in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeElement
                                            Must Supporttrue
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            100. Dosage.doseAndRate.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            102. Dosage.doseAndRate.extension
                                            Definition

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

                                            ShortAdditional content defined by implementations
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standard StatusNormative (from Trial Use)
                                            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 Dosage.doseAndRate.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 104. Dosage.doseAndRate.type
                                              Definition

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

                                              ShortThe kind of dose or rate specified
                                              Comments

                                              Begründung Einschränkung Kardinalität: Eine 'type'-Angabe ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                              Control0..0
                                              This element is affected by the following invariants: ele-1
                                              BindingFor example codes, see DoseAndRateType
                                              (example to http://hl7.org/fhir/ValueSet/dose-rate-type)

                                              The kind of dose or rate specified.

                                              TypeCodeableConcept
                                              Summarytrue
                                              Requirements

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

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

                                              Amount of medication per dose.

                                              ShortAmount of medication per dose
                                              Comments

                                              Begründung Einschränkung Datentyp: Nur einfache Mengenangaben sind in der ersten Ausbaustufe des dgMP vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeQuantity(SimpleQuantity)
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Summarytrue
                                              Requirements

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

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

                                                Menge des Medikaments pro Dosis.

                                                ShortMenge des Medikaments pro Dosis
                                                Comments

                                                Beachten Sie, dass dies die Menge des angegebenen Medikaments angibt, nicht die Menge für die einzelnen Wirkstoffe. Jede Wirkstoffmenge kann in der Medication-Ressource kommuniziert werden. Zum Beispiel, wenn man angeben möchte, dass eine Tablette 375 mg enthält und die Dosis eine Tablette beträgt, kann man die Medication-Ressource verwenden, um zu dokumentieren, dass die Tablette aus 375 mg des Wirkstoffs XYZ besteht. Alternativ, wenn die Dosis 375 mg beträgt, muss man möglicherweise nur angeben, dass es sich um eine Tablette handelt. Bei einer Infusion wie Dopamin, bei der 400 mg Dopamin in 500 ml einer Infusionslösung gemischt werden, würde dies alles in der Medication-Ressource kommuniziert werden. Wenn die Verabreichung nicht als sofortig vorgesehen ist (Rate ist vorhanden oder Timing hat eine Dauer), kann dies angegeben werden, um die Gesamtmenge anzugeben, die über den im Zeitplan angegebenen Zeitraum verabreicht werden soll, z. B. 500 ml in der Dosis, wobei Timing verwendet wird, um anzugeben, dass dies über 4 Stunden erfolgen soll.

                                                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_BMP_DOSIEREINHEIT
                                                (required to https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_BMP_DOSIEREINHEIT)
                                                TypeQuantity(SimpleQuantity)
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Must Supporttrue
                                                Summarytrue
                                                Requirements

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

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

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

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

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Standard StatusNormative (from Trial Use)
                                                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 Dosage.doseAndRate.dose[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 114. Dosage.doseAndRate.dose[x]:doseQuantity.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
                                                  This element is affected by the following invariants: ele-1
                                                  Typedecimal
                                                  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()))
                                                  116. Dosage.doseAndRate.dose[x]:doseQuantity.comparator
                                                  Definition

                                                  Not allowed to be used in this context

                                                  Short< | <= | >= | > - how to understand the value
                                                  Comments

                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                  Control0..0
                                                  This element is affected by the following invariants: ele-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()))
                                                  118. Dosage.doseAndRate.dose[x]:doseQuantity.unit
                                                  Definition

                                                  A human-readable form of the unit.

                                                  ShortUnit representation
                                                  Comments

                                                  Note that FHIR strings SHALL NOT exceed 1MB in size

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  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()))
                                                  120. Dosage.doseAndRate.dose[x]:doseQuantity.system
                                                  Definition

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

                                                  ShortSystem that defines coded unit form
                                                  Comments

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

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1, qty-3
                                                  Typeuri
                                                  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()))
                                                  122. Dosage.doseAndRate.dose[x]:doseQuantity.code
                                                  Definition

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

                                                  ShortCoded form of the unit
                                                  Comments

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

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typecode
                                                  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()))
                                                  124. Dosage.doseAndRate.rate[x]
                                                  Definition

                                                  Amount of medication per unit of time.

                                                  ShortAmount of medication per unit of time
                                                  Comments

                                                  Begründung Einschränkung Kardinalität: Eine Verabreichungsmenge pro Zeiteinheit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                  Control0..0
                                                  This element is affected by the following invariants: ele-1
                                                  TypeChoice of: Ratio, Range, Quantity(SimpleQuantity)
                                                  Summarytrue
                                                  Requirements

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

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

                                                  Upper limit on medication per unit of time.

                                                  ShortUpper limit on medication per unit of time
                                                  Comments

                                                  Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Zeitraum ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                  Control0..0
                                                  This element is affected by the following invariants: ele-1
                                                  TypeRatio
                                                  Summarytrue
                                                  Requirements

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

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

                                                  Upper limit on medication per administration.

                                                  ShortUpper limit on medication per administration
                                                  Comments

                                                  Begründung Einschränkung Kardinalität: Eine maximale Dosis pro Verabreichung ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                  Control0..0
                                                  This element is affected by the following invariants: ele-1
                                                  TypeQuantity(SimpleQuantity)
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

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

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                  130. Dosage.maxDosePerLifetime
                                                  Definition

                                                  Upper limit on medication per lifetime of the patient.

                                                  ShortUpper limit on medication per lifetime of the patient
                                                  Comments

                                                  Begründung Einschränkung Kardinalität: Eine maximale Dosis über die Lebenszeit ist in der ersten Ausbaustufe des dgMP nicht vorgesehen, um die Komplexität zu reduzieren und die Übersichtlichkeit zu erhöhen.

                                                  Control0..0
                                                  This element is affected by the following invariants: ele-1
                                                  TypeQuantity(SimpleQuantity)
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

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

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())