Medication Prescription and Dispense (MPD)
0.1.0 - ci-build International flag

Medication Prescription and Dispense (MPD), published by Integrating the Healthcare Enterprise (IHE). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/pharm-mpd/tree/master and changes regularly. See the Directory of published versions

Logical Model: Medication order (model)

Official URL: http://profiles.ihe.net/PHARM/MPD/StructureDefinition/IHEMedicationOrderModel Version: 0.1.0
Active as of 2025-04-19 Computable Name: IHEMedicationOrderModel

Copyright/Legal: IHE http://www.ihe.net/Governance/#Intellectual_Property

Logical model for medication prescription or other types of medication orders

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. IHEMedicationOrderModel 0..* Base Medication order (model)
Instances of this logical model can be the target of a Reference
... groupIdentifier 0..1 Identifier Identifier for the group that this prescription belongs to. This might be the common identifier in use cases where one national prescription contains several medication items, which can be handled as separate orders
... identifier 1..* Identifier Business identifier(s) for the prescription
... prescriber 1..1 Reference(Practitioner (model) | PractitionerRole) The person who made the prescription, and who takes the responsibility of the treatment
... issueDate 1..1 dateTime Time of issuing (signing) the prescription by health care practicioner
... patient 1..1 Reference(Patient (model)) The person for whom the medication is prescribed/ordered
... recorder 0..1 Reference(Practitioner (model) | PractitionerRole) The recorder of the prescription/draft in the information system
... recordingDate 0..1 dateTime Time of authoring the prescription/draft in the information system
... status 1..1 CodeableConcept Status of the prescription, this should not be status of treatment
... statusReason 0..* CodeableConcept Reason for the current status of prescription, for example the reason why the prescription was made invalid
... basedOn 0..1 Reference(IHE Medication Order) What this order is based on
... category 0..* CodeableConcept Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc).
... validFrom 0..1 dateTime Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate
... validUntil 0..1 dateTime The validity period end date. The prescription is not dispensable after this date.
... prescriptionIntent 0..1 CodeableConcept Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc
... medication 1..1 Reference(Medicinal product (model)) Prescribed product, branded, generic, virtual, extemporal, etc
... indication 0..* CodeableConcept Reason for the prescription (typically diagnosis, prophylaxis, or a procedure)
... indicationText 0..* string Reason for the prescription in textual form. This might not be allowed by some implementations.
... indicationReference 0..* string Reason for the prescription - as a reference to a problem, result, etc.
... treatmentPeriod 0..1 Period Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.)
... quantityPrescribed 0..1 Quantity Overall quantity of prescribed product (e.g number of packages or number of tablets).
... dosageInstructions 0..* Reference(Dosaging (model)) Dosaging and administration instructions
... preparationInstructions 0..1 string Additional instructions about preparation or dispense
... substitution 0..1 BackboneElement Whether and which type of substitution is allowed for this medication treatment line
ele-1: All FHIR elements must have a @value or children
.... @id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... allowed[x] 0..1 Whether substitution is allowed or not (or type of substitution).
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason[x] 0..1 Reason for the substitution requirement
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... offLabel 0..1 Base Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.
.... isOffLabelUse 1..1 boolean Indicates off-label use. Must be 'true' when .reason is provided.
.... reason[x] 0..* Reason or related clarification for off-label use.
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... repeatsAllowed 0..1 integer Number of refills authorized
... minimumDispenseInterval 0..1 Duration Minimum Dispense Interval
... comment 0..* string Additional information or comments

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraintsdoco
.. IHEMedicationOrderModel 0..* Base Medication order (model)
Instances of this logical model can be the target of a Reference
... groupIdentifier 0..1 Identifier Identifier for the group that this prescription belongs to. This might be the common identifier in use cases where one national prescription contains several medication items, which can be handled as separate orders
... identifier 1..* Identifier Business identifier(s) for the prescription
... prescriber 1..1 Reference(Practitioner (model) | PractitionerRole) The person who made the prescription, and who takes the responsibility of the treatment
... issueDate 1..1 dateTime Time of issuing (signing) the prescription by health care practicioner
... patient 1..1 Reference(Patient (model)) The person for whom the medication is prescribed/ordered
... recorder 0..1 Reference(Practitioner (model) | PractitionerRole) The recorder of the prescription/draft in the information system
... recordingDate 0..1 dateTime Time of authoring the prescription/draft in the information system
... status 1..1 CodeableConcept Status of the prescription, this should not be status of treatment
... statusReason 0..* CodeableConcept Reason for the current status of prescription, for example the reason why the prescription was made invalid
... basedOn 0..1 Reference(IHE Medication Order) What this order is based on
... category 0..* CodeableConcept Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc).
... validFrom 0..1 dateTime Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate
... validUntil 0..1 dateTime The validity period end date. The prescription is not dispensable after this date.
... prescriptionIntent 0..1 CodeableConcept Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc
... medication 1..1 Reference(Medicinal product (model)) Prescribed product, branded, generic, virtual, extemporal, etc
... indication 0..* CodeableConcept Reason for the prescription (typically diagnosis, prophylaxis, or a procedure)
... indicationText 0..* string Reason for the prescription in textual form. This might not be allowed by some implementations.
... indicationReference 0..* string Reason for the prescription - as a reference to a problem, result, etc.
... treatmentPeriod 0..1 Period Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.)
... quantityPrescribed 0..1 Quantity Overall quantity of prescribed product (e.g number of packages or number of tablets).
... dosageInstructions 0..* Reference(Dosaging (model)) Dosaging and administration instructions
... preparationInstructions 0..1 string Additional instructions about preparation or dispense
... substitution 0..1 BackboneElement Whether and which type of substitution is allowed for this medication treatment line
.... allowed[x] 0..1 Whether substitution is allowed or not (or type of substitution).
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason[x] 0..1 Reason for the substitution requirement
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... offLabel 0..1 Base Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.
.... isOffLabelUse 1..1 boolean Indicates off-label use. Must be 'true' when .reason is provided.
.... reason[x] 0..* Reason or related clarification for off-label use.
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... repeatsAllowed 0..1 integer Number of refills authorized
... minimumDispenseInterval 0..1 Duration Minimum Dispense Interval
... comment 0..* string Additional information or comments

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. IHEMedicationOrderModel 0..* Base Medication order (model)
Instances of this logical model can be the target of a Reference
... groupIdentifier 0..1 Identifier Identifier for the group that this prescription belongs to. This might be the common identifier in use cases where one national prescription contains several medication items, which can be handled as separate orders
... identifier 1..* Identifier Business identifier(s) for the prescription
... prescriber 1..1 Reference(Practitioner (model) | PractitionerRole) The person who made the prescription, and who takes the responsibility of the treatment
... issueDate 1..1 dateTime Time of issuing (signing) the prescription by health care practicioner
... patient 1..1 Reference(Patient (model)) The person for whom the medication is prescribed/ordered
... recorder 0..1 Reference(Practitioner (model) | PractitionerRole) The recorder of the prescription/draft in the information system
... recordingDate 0..1 dateTime Time of authoring the prescription/draft in the information system
... status 1..1 CodeableConcept Status of the prescription, this should not be status of treatment
... statusReason 0..* CodeableConcept Reason for the current status of prescription, for example the reason why the prescription was made invalid
... basedOn 0..1 Reference(IHE Medication Order) What this order is based on
... category 0..* CodeableConcept Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc).
... validFrom 0..1 dateTime Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate
... validUntil 0..1 dateTime The validity period end date. The prescription is not dispensable after this date.
... prescriptionIntent 0..1 CodeableConcept Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc
... medication 1..1 Reference(Medicinal product (model)) Prescribed product, branded, generic, virtual, extemporal, etc
... indication 0..* CodeableConcept Reason for the prescription (typically diagnosis, prophylaxis, or a procedure)
... indicationText 0..* string Reason for the prescription in textual form. This might not be allowed by some implementations.
... indicationReference 0..* string Reason for the prescription - as a reference to a problem, result, etc.
... treatmentPeriod 0..1 Period Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.)
... quantityPrescribed 0..1 Quantity Overall quantity of prescribed product (e.g number of packages or number of tablets).
... dosageInstructions 0..* Reference(Dosaging (model)) Dosaging and administration instructions
... preparationInstructions 0..1 string Additional instructions about preparation or dispense
... substitution 0..1 BackboneElement Whether and which type of substitution is allowed for this medication treatment line
.... @id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 0..1 Whether substitution is allowed or not (or type of substitution).
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason[x] 0..1 Reason for the substitution requirement
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... offLabel 0..1 Base Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.
.... isOffLabelUse 1..1 boolean Indicates off-label use. Must be 'true' when .reason is provided.
.... reason[x] 0..* Reason or related clarification for off-label use.
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... repeatsAllowed 0..1 integer Number of refills authorized
... minimumDispenseInterval 0..1 Duration Minimum Dispense Interval
... comment 0..* string Additional information or comments

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. IHEMedicationOrderModel 0..* Base Medication order (model)
Instances of this logical model can be the target of a Reference
... groupIdentifier 0..1 Identifier Identifier for the group that this prescription belongs to. This might be the common identifier in use cases where one national prescription contains several medication items, which can be handled as separate orders
... identifier 1..* Identifier Business identifier(s) for the prescription
... prescriber 1..1 Reference(Practitioner (model) | PractitionerRole) The person who made the prescription, and who takes the responsibility of the treatment
... issueDate 1..1 dateTime Time of issuing (signing) the prescription by health care practicioner
... patient 1..1 Reference(Patient (model)) The person for whom the medication is prescribed/ordered
... recorder 0..1 Reference(Practitioner (model) | PractitionerRole) The recorder of the prescription/draft in the information system
... recordingDate 0..1 dateTime Time of authoring the prescription/draft in the information system
... status 1..1 CodeableConcept Status of the prescription, this should not be status of treatment
... statusReason 0..* CodeableConcept Reason for the current status of prescription, for example the reason why the prescription was made invalid
... basedOn 0..1 Reference(IHE Medication Order) What this order is based on
... category 0..* CodeableConcept Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc).
... validFrom 0..1 dateTime Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate
... validUntil 0..1 dateTime The validity period end date. The prescription is not dispensable after this date.
... prescriptionIntent 0..1 CodeableConcept Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc
... medication 1..1 Reference(Medicinal product (model)) Prescribed product, branded, generic, virtual, extemporal, etc
... indication 0..* CodeableConcept Reason for the prescription (typically diagnosis, prophylaxis, or a procedure)
... indicationText 0..* string Reason for the prescription in textual form. This might not be allowed by some implementations.
... indicationReference 0..* string Reason for the prescription - as a reference to a problem, result, etc.
... treatmentPeriod 0..1 Period Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.)
... quantityPrescribed 0..1 Quantity Overall quantity of prescribed product (e.g number of packages or number of tablets).
... dosageInstructions 0..* Reference(Dosaging (model)) Dosaging and administration instructions
... preparationInstructions 0..1 string Additional instructions about preparation or dispense
... substitution 0..1 BackboneElement Whether and which type of substitution is allowed for this medication treatment line
ele-1: All FHIR elements must have a @value or children
.... @id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... allowed[x] 0..1 Whether substitution is allowed or not (or type of substitution).
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason[x] 0..1 Reason for the substitution requirement
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... offLabel 0..1 Base Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.
.... isOffLabelUse 1..1 boolean Indicates off-label use. Must be 'true' when .reason is provided.
.... reason[x] 0..* Reason or related clarification for off-label use.
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... repeatsAllowed 0..1 integer Number of refills authorized
... minimumDispenseInterval 0..1 Duration Minimum Dispense Interval
... comment 0..* string Additional information or comments

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraintsdoco
.. IHEMedicationOrderModel 0..* Base Medication order (model)
Instances of this logical model can be the target of a Reference
... groupIdentifier 0..1 Identifier Identifier for the group that this prescription belongs to. This might be the common identifier in use cases where one national prescription contains several medication items, which can be handled as separate orders
... identifier 1..* Identifier Business identifier(s) for the prescription
... prescriber 1..1 Reference(Practitioner (model) | PractitionerRole) The person who made the prescription, and who takes the responsibility of the treatment
... issueDate 1..1 dateTime Time of issuing (signing) the prescription by health care practicioner
... patient 1..1 Reference(Patient (model)) The person for whom the medication is prescribed/ordered
... recorder 0..1 Reference(Practitioner (model) | PractitionerRole) The recorder of the prescription/draft in the information system
... recordingDate 0..1 dateTime Time of authoring the prescription/draft in the information system
... status 1..1 CodeableConcept Status of the prescription, this should not be status of treatment
... statusReason 0..* CodeableConcept Reason for the current status of prescription, for example the reason why the prescription was made invalid
... basedOn 0..1 Reference(IHE Medication Order) What this order is based on
... category 0..* CodeableConcept Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc).
... validFrom 0..1 dateTime Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate
... validUntil 0..1 dateTime The validity period end date. The prescription is not dispensable after this date.
... prescriptionIntent 0..1 CodeableConcept Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc
... medication 1..1 Reference(Medicinal product (model)) Prescribed product, branded, generic, virtual, extemporal, etc
... indication 0..* CodeableConcept Reason for the prescription (typically diagnosis, prophylaxis, or a procedure)
... indicationText 0..* string Reason for the prescription in textual form. This might not be allowed by some implementations.
... indicationReference 0..* string Reason for the prescription - as a reference to a problem, result, etc.
... treatmentPeriod 0..1 Period Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.)
... quantityPrescribed 0..1 Quantity Overall quantity of prescribed product (e.g number of packages or number of tablets).
... dosageInstructions 0..* Reference(Dosaging (model)) Dosaging and administration instructions
... preparationInstructions 0..1 string Additional instructions about preparation or dispense
... substitution 0..1 BackboneElement Whether and which type of substitution is allowed for this medication treatment line
.... allowed[x] 0..1 Whether substitution is allowed or not (or type of substitution).
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason[x] 0..1 Reason for the substitution requirement
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... offLabel 0..1 Base Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.
.... isOffLabelUse 1..1 boolean Indicates off-label use. Must be 'true' when .reason is provided.
.... reason[x] 0..* Reason or related clarification for off-label use.
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... repeatsAllowed 0..1 integer Number of refills authorized
... minimumDispenseInterval 0..1 Duration Minimum Dispense Interval
... comment 0..* string Additional information or comments

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. IHEMedicationOrderModel 0..* Base Medication order (model)
Instances of this logical model can be the target of a Reference
... groupIdentifier 0..1 Identifier Identifier for the group that this prescription belongs to. This might be the common identifier in use cases where one national prescription contains several medication items, which can be handled as separate orders
... identifier 1..* Identifier Business identifier(s) for the prescription
... prescriber 1..1 Reference(Practitioner (model) | PractitionerRole) The person who made the prescription, and who takes the responsibility of the treatment
... issueDate 1..1 dateTime Time of issuing (signing) the prescription by health care practicioner
... patient 1..1 Reference(Patient (model)) The person for whom the medication is prescribed/ordered
... recorder 0..1 Reference(Practitioner (model) | PractitionerRole) The recorder of the prescription/draft in the information system
... recordingDate 0..1 dateTime Time of authoring the prescription/draft in the information system
... status 1..1 CodeableConcept Status of the prescription, this should not be status of treatment
... statusReason 0..* CodeableConcept Reason for the current status of prescription, for example the reason why the prescription was made invalid
... basedOn 0..1 Reference(IHE Medication Order) What this order is based on
... category 0..* CodeableConcept Category or categories of prescription. For example type of reimbursement, or type of prescription (e.g. hospital, private, etc).
... validFrom 0..1 dateTime Effective date of the prescription. The prescription is not dispensable before this date. In most cases this information repeats issueDate
... validUntil 0..1 dateTime The validity period end date. The prescription is not dispensable after this date.
... prescriptionIntent 0..1 CodeableConcept Type of intent of the prescription - prophylaxis, treatment, anesthesia, etc
... medication 1..1 Reference(Medicinal product (model)) Prescribed product, branded, generic, virtual, extemporal, etc
... indication 0..* CodeableConcept Reason for the prescription (typically diagnosis, prophylaxis, or a procedure)
... indicationText 0..* string Reason for the prescription in textual form. This might not be allowed by some implementations.
... indicationReference 0..* string Reason for the prescription - as a reference to a problem, result, etc.
... treatmentPeriod 0..1 Period Period over which the medication is to be taken (in case of multiple dosaging schemes, this would be the overall period of all dosages.)
... quantityPrescribed 0..1 Quantity Overall quantity of prescribed product (e.g number of packages or number of tablets).
... dosageInstructions 0..* Reference(Dosaging (model)) Dosaging and administration instructions
... preparationInstructions 0..1 string Additional instructions about preparation or dispense
... substitution 0..1 BackboneElement Whether and which type of substitution is allowed for this medication treatment line
.... @id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... allowed[x] 0..1 Whether substitution is allowed or not (or type of substitution).
..... allowedBoolean boolean
..... allowedCodeableConcept CodeableConcept
.... reason[x] 0..1 Reason for the substitution requirement
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... offLabel 0..1 Base Indicates that the prescriber has knowingly prescribed the medication for an indication, age group, dosage, or route of administration that is not approved by the regulatory agencies and is not mentioned in the prescribing information for the product.
.... isOffLabelUse 1..1 boolean Indicates off-label use. Must be 'true' when .reason is provided.
.... reason[x] 0..* Reason or related clarification for off-label use.
..... reasonCodeableConcept CodeableConcept
..... reasonString string
... repeatsAllowed 0..1 integer Number of refills authorized
... minimumDispenseInterval 0..1 Duration Minimum Dispense Interval
... comment 0..* string Additional information or comments

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel

Notes:

Detailed diagram:

IHEMedicationOrderModelgroupIdentifier 0..1identifier 1..*prescriber 1..1issueDate 1..1patient 1..1recorder 0..1recordingDate 0..1status 1..1statusReason 0..*basedOn 0..1category 0..*validFrom 0..1validUntil 0..1prescriptionIntent 0..1medication 1..1indication 0..*indicationText 0..*indicationReference 0..*treatmentPeriod 0..1quantityPrescribed 0..1dosageInstructions 0..*preparationInstructions 0..1substitution 0..1allowed[x] 0..1reason[x] 0..1offLabel 0..1isOffLabelUse 1..1reason[x] 0..*repeatsAllowed 0..1minimumDispenseInterval 0..1comment 0..*