340B FHIR Exchange Implementation Guide - Local Development build (v0.1.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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• XML
• JSON
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: dispense-reversal-001 - XML Representation

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<MedicationDispense xmlns="http://hl7.org/fhir">
  <id value="dispense-reversal-001"/>
  <meta>
    <profile
             value="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-medication-dispense"/>
  </meta>
  <text>
    <status value="extensions"/>
    <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>
  </text>
  <extension
             url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id">
    <valueString value="corr-9001"/>
  </extension>
  <extension
             url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id">
    <valueString value="tx-disp-rev-0001"/>
  </extension>
  <extension
             url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-ce-id">
    <valueIdentifier>
      <system value="https://exchange.example.org/covered-entities"/>
      <value value="ce-456"/>
    </valueIdentifier>
  </extension>
  <extension
             url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-reversal-reference">
    <valueIdentifier>
      <system value="https://exchange.example.org/dispense-ids"/>
      <value value="disp-001"/>
    </valueIdentifier>
  </extension>
  <identifier>
    <system value="https://exchange.example.org/dispense-ids"/>
    <value value="disp-rev-001"/>
  </identifier>
  <status value="entered-in-error"/>
  <medicationCodeableConcept>
    <coding>
      <system value="http://example.org/drug-codes"/>
      <code value="00000-1111-22"/>
      <display value="Example Drug 100mg"/>
    </coding>
  </medicationCodeableConcept>
  <subject>🔗 
    <reference value="Patient/p-001"/>
  </subject>
  <performer>
    <actor>🔗 
      <reference value="Organization/pharmacy-22"/>
    </actor>
  </performer>
  <quantity>
    <value value="30"/>
    <unit value="{tbl}"/>
    <system value="http://unitsofmeasure.org"/>
    <code value="{tbl}"/>
  </quantity>
  <whenHandedOver value="2026-04-24T10:30:00Z"/>
</MedicationDispense>