<supply classCode=“SPLY” moodCode=“RQO”>

<!-- Immunization Supply Request template -->
 <templateId root="2.16.840.1.113883.10.20.24.3.167" extension="2019-12-01"/>
 <!-- Conforms to C-CDA R2 Planned Supply (V2) template-->
 <templateId root="2.16.840.1.113883.10.20.22.4.43" extension="2014-06-09" />
 <id root="{{random_id}}"/>
 <statusCode code="active"/>
 {{#relevantPeriod}}
 {{{medication_supply_request_period}}}
 {{/relevantPeriod}}
 {{^relevantPeriod}}
   {{#authorDatetime}}
   {{{author_effective_time}}}
   {{/authorDatetime}}
 {{/relevantPeriod}}
 <quantity value="{{{value_as_float}}}"/>
 <product>
   <manufacturedProduct classCode="MANU">
     <!-- Immunization Medication Information (consolidation) template -->
     <templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
     <id root="{{random_id}}"/>
     <manufacturedMaterial>
       <!--  QDM Attribute: Code -->
       {{> _codes}}
       <lotNumberText>1</lotNumberText>
     </manufacturedMaterial>
   </manufacturedProduct>
 </product>

</supply>