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Source1

{
  "resourceType": "MedicationDispense",
  "id": "pdmp-meddispense-1",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2023-06-05T06:38:52Z",
    "source": "http://example.org/ma-pdmp",
    "profile": [
      "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-medicationdispense"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number",
      "valuePositiveInt": 1
    },
    {
      "url": "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method",
      "valueCoding": {
        "system": "http://terminology.hl7.org/CodeSystem/PMIXTransmissionFormRxOriginCodeType",
        "code": "05",
        "display": "Electronic Prescription"
      }
    },
    {
      "url": "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-mme",
      "valueDecimal": 18
    },
    {
      "url": "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-method-of-payment",
      "valueCoding": {
        "system": "http://terminology.hl7.org/CodeSystem/PMIXMethodofPayment",
        "code": "01",
        "display": "Private Pay (Cash, Charge, Credit Card)"
      }
    },
    {
      "url": "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-opioid-treatment-code",
      "valueCoding": {
        "system": "http://terminology.hl7.org/CodeSystem/PMIXOpioidTreatmentCode",
        "code": "10",
        "display": "Acute Opioid Therapy"
      }
    }
  ],
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "FILL",
            "display": "Filler Identifier"
          }
        ]
      },
      "system": "http://ourpharmacy.com/fillnumber",
      "value": "2000353"
    }
  ],
  "status": "completed",
  "medicationCodeableConcept": {
    "coding": [
      {
        "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code": "993781",
        "display": "acetaminophen 300 MG / codeine phosphate 30 MG Oral Tablet"
      },
      {
        "system": "http://hl7.org/fhir/sid/ndc",
        "code": "00093015001",
        "userSelected": true
      }
    ],
    "text": "Acetaminophen 300 mg / Codeine 30 mg oral tablet"
  },
  "subject": {
    "reference": "urn:uuid:53a1e123-5b56-44ae-b7e8-36e0b9800f57",
    "display": "August Samuels"
  },
  "performer": [
    {
      "actor": {
        "reference": "urn:uuid:82ae67e4-f23a-4c17-b80a-9076a37f5d6e",
        "identifier": {
          "system": "http://terminology.hl7.org/CodeSystem/NCPDPProviderIdentificationNumber",
          "value": "999017"
        },
        "display": "Our Pharmacy"
      }
    }
  ],
  "authorizingPrescription": [
    {
      "identifier": {
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
              "code": "FILL",
              "display": "Filler Identifier"
            }
          ]
        },
        "system": "http://mypharmacysystem.com/prescriptionnumber",
        "value": "065046045550"
      }
    }
  ],
  "quantity": {
    "value": 15,
    "unit": "each"
  },
  "daysSupply": {
    "value": 5
  },
  "whenPrepared": "2023-06-05",
  "_whenHandedOver": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
        "valueCode": "unknown"
      }
    ]
  },
  "dosageInstruction": [
    {
      "sequence": 1,
      "text": "1 tablet every 6-8 hours as needed for pain"
    }
  ]
}