Consider the following resolution. Only elements currently in QI-Core 5.0.1 and US Core 6.1.0 that differ are listed in this table.  NOTE that US Core 6.1.0 is the first use of the MedicationDispense profile in US Core.  Note that, unless the element has a MS flag in US Core 6.1.0, we should include those Keep element in the Key Elements Table for QICore but not add an MS Flag. Add (QM) to description of all Keep or Add elements such that that will be included in the Key Elements Table for QI-Core.  This set of elements is consistent with the FHIR-41511 disposition for QI-CoreMedicationDispenseDeclined and USCoreMedicationDispense to assure harmonization across QI-Core and with the US Core version 6.1.0 version. QI-Core Profile-based path Action Include in QI-Core 6.0 Justification QICoreMedicationDispense. daysSupply Keep YES Not present in US Core 6.1.0 but used for Cumulative Medication Duration. Retain as is. QICoreMedicationDispense. medication[x] Keep YES (change to extensible binding as with US Core) Change to extensible binding.  Note this is the same value set used in QI-Core 5.0.1 in US Core extensible binding to  Medication Clinical Drug  which contains 81,405 items from RxNorm. QICoreMedicationDispense. quantity Keep YES USCDI and US Core 6.1.0 Amount dispensed; QI-Core currently indicates SimpleQuantity while US Core indicates Quantity and QI-Core does not indicate a binding – ALIGN with US Core datatype Quantity with binding: Common UCUM units ([preferred http://hl7.org/fhir/R4/terminologies.html#preferred ]),  UCUMCodes  Max Binding QICoreMedicationDispense. status Keep YES (Constrained value set compared to US Core) USCDI and US Core 6.1.0 element. To assure disjoint profiles with QICoreMedicationDispenseDeclined, use required binding to  Non-Negative MedicationDispense Status  (which includes all codes present in US Core required binding  MedicationDispense Status Codes  with the exception of  declined ) QICoreMedicationDispense. dosageInstruction.   text Add YES USCDI and US Core 6.1.0. While text won’t appear in our Pattern, it comes in from US Core. QICoreMedicationDispense. dosageInstruction.   site Remove NO Currently in QI-Core; Not in USCDI or US Core 6.1.0 and not used in CMD calculation QICoreMedicationDispense. dosageInstruction.   route Remove NO  Not in USCDI or US Core 6.1.0 and not used in CMD calculation. Value sets can determine exclusion medications, by selecting RxNorm codes for the appropriate route I.e., those prescribed for specific sites (topical, parenteral). QICoreMedicationDispense. dosageInstruction. doseAndRate.   type Remove NO  Not in USCDI or US Core 6.1.0 and not used in CMD calculation. Currently with preferred binding to  QICore SNOMED CT Dosage Codes . The kind of dose or rate specified (loading, maintenance). Has potential future use but no clear use case in CMD with current calculations. QICoreMedicationDispense. dosageInstruction. doseAndRate.   dose[x] Keep YES  USCDI and US Core 6.1.0 and used in CMD calculation. Add US Core binding  Common UCUM units  (preferred) and additional bindings to  UCUMCodes  Max binding NOTE: elements  QICoreMedicationDispense. dosageInstruction. doseAndRate.   dose[x]. doseRange Keep YES Not in USCDI or US Core 6.1.0 Key Element table but assists in CMD for as needed medications QICoreMedicationDispense. dosageInstruction. doseAndRate.   dose[x] .dose Keep YES  USCDI and US Core 6.1.0 - However, QI-Core uses datatype Quantity(SimpleQuantity). US Core uses Quantity -Change to Quantity QICoreMedicationDispense.extension:recorded Do not add NO This extension is only needed for MedicationDispenseDeclined to indicate when the decision not to dispense occurred. It is not currently present in MedicationDispense and it is not needed for this profile.         QICoreMedicationDispense. statusReason[x] Remove NO Not MS or required in US Core 6.1.0; no existing use case for this element in current measures in MedicationDispense – used in MedicationDispenseDeclined. QICoreMedicationDispense. subject Keep YES (Reference change from US Core) USCDI and US Core 6.1.0 - retain reference to QICorePatient QICoreMedicationDispense. authorizingPrescription Keep YES (Reference change from US Core) USCDI and US Core 6.1.0 - retain reference to QICoreMedicationRequest QICoreMedicationDispense. type ADD YES USCDI and US Core 6.1.0, cardinality 0..1 with extensible binding to  ActPharmacySupplyType . Trial fill, partial fill, emergency fill, etc.  ---- Not sure it will be used in CMD QICoreMedicationDispense. whenPrepared Keep YES Not present in USCDI or US Core 6.1.0 but used in CMD calculations as a default if  whenHandedOver  is absent. Retain as is. QICoreMedicationDispense. destination Remove NO Not in USCDI or US Core and no existing use case QICoreMedicationDispense. receiver Remove NO Not in USCDI or US Core and no existing use case QICoreMedicationDispense. substitution Remove NO Not in USCDI or US Core and no existing use case QICoreMedicationDispense.substitution. modifierExtension Remove NO Not in USCDI or US Core and no existing use case QICoreMedicationDispense.substitution. wasSubstituted Remove NO Not in USCDI or US Core and no existing use case QICoreMedicationDispense.substitution. responsibleParty Remove NO Not in USCDI or US Core and no existing use case