{
  "resourceType" : "MedicationDispense",
  "id" : "dispense-reversal-001",
  "meta" : {
    "profile" : ["https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-medication-dispense"]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: MedicationDispense dispense-reversal-001</b></p><a name=\"dispense-reversal-001\"> </a><a name=\"hcdispense-reversal-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-340b-medication-dispense.html\">340B Medication Dispense Profile</a></p></div><p><b>340B Correlation ID Extension</b>: corr-9001</p><p><b>340B Exchange Transaction ID Extension</b>: tx-disp-rev-0001</p><p><b>340B Covered Entity ID Extension</b>: <code>https://exchange.example.org/covered-entities</code>/ce-456</p><p><b>340B Reversal Reference Extension</b>: <code>https://exchange.example.org/dispense-ids</code>/disp-001</p><p><b>identifier</b>: <code>https://exchange.example.org/dispense-ids</code>/disp-rev-001</p><p><b>status</b>: Entered in Error</p><p><b>medication</b>: <span title=\"Codes:{http://example.org/drug-codes 00000-1111-22}\">Example Drug 100mg</span></p><p><b>subject</b>: <a href=\"Patient-p-001.html\">Pat Example  (no stated gender), DoB Unknown</a></p><h3>Performers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Actor</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Organization-pharmacy-22.html\">Organization Example Pharmacy 22</a></td></tr></table><p><b>quantity</b>: 30 {tbl}<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code{tbl} = '{tbl}')</span></p><p><b>whenHandedOver</b>: 2026-04-24 10:30:00+0000</p></div>"
  },
  "extension" : [{
    "url" : "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id",
    "valueString" : "corr-9001"
  },
  {
    "url" : "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id",
    "valueString" : "tx-disp-rev-0001"
  },
  {
    "url" : "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-ce-id",
    "valueIdentifier" : {
      "system" : "https://exchange.example.org/covered-entities",
      "value" : "ce-456"
    }
  },
  {
    "url" : "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-reversal-reference",
    "valueIdentifier" : {
      "system" : "https://exchange.example.org/dispense-ids",
      "value" : "disp-001"
    }
  }],
  "identifier" : [{
    "system" : "https://exchange.example.org/dispense-ids",
    "value" : "disp-rev-001"
  }],
  "status" : "entered-in-error",
  "medicationCodeableConcept" : {
    "coding" : [{
      "system" : "http://example.org/drug-codes",
      "code" : "00000-1111-22",
      "display" : "Example Drug 100mg"
    }]
  },
  "subject" : {
    "reference" : "Patient/p-001"
  },
  "performer" : [{
    "actor" : {
      "reference" : "Organization/pharmacy-22"
    }
  }],
  "quantity" : {
    "value" : 30,
    "unit" : "{tbl}",
    "system" : "http://unitsofmeasure.org",
    "code" : "{tbl}"
  },
  "whenHandedOver" : "2026-04-24T10:30:00Z"
}