Consider the following resolution.  While this profile has not been used in existing eCQMs for CMS programs, inclusion of this negation example is consistent with other QI-Core action profiles. 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 disposition for QI-CoreMedicationDispense 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. medication[x] Keep YES – This is the same value set used in  QI-Core 5.0. 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.medication [x] .extension:  notDoneValueSet Keep YES Url of a value set of activities not requested or performed URL:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet QICoreMedicationDispense. status Keep -  Update value set binding YES (Change value set binding to QI-Core’s constrained value set) 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 ). This represents a change for QI-Core since the 5.0.1 version does not use the Non-negative Medication Dispense Status and it should have used this constrained values set. QICoreMedicationDispense. dosageInstruction Keep YES NOTE - these dosageInstruction elements need to be in the profile to align with USCDI and US Core 6.1.0 and QI-Core MedicationDispense but since cardinality of the .dosageInstruction is 0.. , NONE of these elements should exist in the Pattern associated with MedicationDispenseDeclined in QI-Core* QICoreMedicationDispense. dosageInstruction.   text Add YES USCDI and US Core 6.1.0  QICoreMedicationDispense. dosageInstruction. timing Keep YES USCDI and US Core 6.1.0 and used in CMD calculation QICoreMedicationDispense. dosageInstruction.   site Remove NO Not in USCDI or US Core 6.1.0 and not used in CMD calculation QICoreMedicationDispense. dosageInstruction.   route Remove/Consider NO Not in USCDI or US Core 6.1.0 and not used in CMD calculation. Consider potential use in CDS to determine exclusion medications, I.e., those prescribed for specific sites (topical, parenteral).