{
  "resourceType": "MedicationStatement",
  "id": "example002",
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0309",
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/sid/ndc",
            "code": "50580-506-02",
            "display": "Tylenol PM"
          }
        ]
      },
      "form": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "385057009",
            "display": "Film-coated tablet (qualifier value)"
          }
        ]
      },
      "ingredient": [
        {
          "itemCodeableConcept": {
            "coding": [
              {
                "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                "code": "315266",
                "display": "Acetaminophen 500 MG"
              }
            ]
          },
          "strength": {
            "numerator": {
              "value": 500,
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            },
            "denominator": {
              "value": 1,
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "Tab"
            }
          }
        },
        {
          "itemCodeableConcept": {
            "coding": [
              {
                "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                "code": "901813",
                "display": "Diphenhydramine Hydrochloride 25 mg"
              }
            ]
          },
          "strength": {
            "numerator": {
              "value": 25,
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            },
            "denominator": {
              "value": 1,
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "Tab"
            }
          }
        }
      ],
      "batch": {
        "lotNumber": "9494788",
        "expirationDate": "2017-05-22"
      }
    }
  ],
  "status": "active",
  "statusReason": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "166643006",
          "display": "Liver enzymes abnormal"
        }
      ]
    }
  ],
  "medicationReference": {
    "reference": "#med0309"
  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "effectiveDateTime": "2015-01-23",
  "dateAsserted": "2015-02-22",
  "informationSource": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "note": [
    {
      "text": "Patient cannot take acetaminophen as per Dr instructions"
    }
  ],
  "meta": {
    "tag": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code": "HTEST",
        "display": "test health data"
      }
    ]
  }
}