ezmedicationinput 0.1.50 → 0.1.53

package/dist/index.js

@@ -38,60 +38,6 @@ var __async = (__this, __arguments, generator) => {
   });
 };
 
-// src/prn.ts
-function getCanonicalPrnReasonText(reason) {
-  var _a2, _b;
-  return (_b = reason == null ? void 0 : reason.text) != null ? _b : (_a2 = reason == null ? void 0 : reason.coding) == null ? void 0 : _a2.display;
-}
-function joinCanonicalPrnReasonTexts(reasons, conjunction = "or") {
-  var _a2;
-  if (!(reasons == null ? void 0 : reasons.length)) {
-    return void 0;
-  }
-  const texts = [];
-  for (const reason of reasons) {
-    const text = (_a2 = getCanonicalPrnReasonText(reason)) == null ? void 0 : _a2.trim();
-    if (!text) {
-      continue;
-    }
-    texts.push(text);
-  }
-  switch (texts.length) {
-    case 0:
-      return void 0;
-    case 1:
-      return texts[0];
-    case 2:
-      return `${texts[0]} ${conjunction} ${texts[1]}`;
-    default: {
-      let combined = "";
-      for (let index = 0; index < texts.length; index += 1) {
-        if (index === 0) {
-          combined = texts[index];
-          continue;
-        }
-        if (index === texts.length - 1) {
-          combined += ` ${conjunction} ${texts[index]}`;
-          continue;
-        }
-        combined += `, ${texts[index]}`;
-      }
-      return combined;
-    }
-  }
-}
-function getPreferredCanonicalPrnReasonText(reason, reasons, conjunction = "or") {
-  var _a2;
-  const direct = (_a2 = getCanonicalPrnReasonText(reason)) == null ? void 0 : _a2.trim();
-  if (!(reasons == null ? void 0 : reasons.length)) {
-    return direct;
-  }
-  if (!direct) {
-    return joinCanonicalPrnReasonTexts(reasons, conjunction);
-  }
-  return /[,/;]/.test(direct) || /\b(?:or|and|and\/or)\b/i.test(direct) || /\s(?:หรือ|และ)\s/.test(direct) ? joinCanonicalPrnReasonTexts(reasons, conjunction) : direct;
-}
-
 // src/types.ts
 var EventTiming = /* @__PURE__ */ ((EventTiming4) => {
   EventTiming4["Before Sleep"] = "HS";
@@ -359,6 +305,328 @@ var AdviceArgumentRole = /* @__PURE__ */ ((AdviceArgumentRole2) => {
   return AdviceArgumentRole2;
 })(AdviceArgumentRole || {});
 
+// src/timing-summary.ts
+var MEAL_TIMING_DETAILS = {
+  ["ACM" /* Before Breakfast */]: { relation: "before", meal: "breakfast" },
+  ["ACD" /* Before Lunch */]: { relation: "before", meal: "lunch" },
+  ["ACV" /* Before Dinner */]: { relation: "before", meal: "dinner" },
+  ["PCM" /* After Breakfast */]: { relation: "after", meal: "breakfast" },
+  ["PCD" /* After Lunch */]: { relation: "after", meal: "lunch" },
+  ["PCV" /* After Dinner */]: { relation: "after", meal: "dinner" },
+  ["CM" /* Breakfast */]: { relation: "with", meal: "breakfast" },
+  ["CD" /* Lunch */]: { relation: "with", meal: "lunch" },
+  ["CV" /* Dinner */]: { relation: "with", meal: "dinner" }
+};
+var MEAL_ORDER = {
+  breakfast: 0,
+  lunch: 1,
+  dinner: 2
+};
+var INFERABLE_DAILY_EVENT_TIMINGS = /* @__PURE__ */ new Set([
+  "HS" /* Before Sleep */,
+  "ACM" /* Before Breakfast */,
+  "ACD" /* Before Lunch */,
+  "ACV" /* Before Dinner */,
+  "PCM" /* After Breakfast */,
+  "PCD" /* After Lunch */,
+  "PCV" /* After Dinner */,
+  "CM" /* Breakfast */,
+  "CD" /* Lunch */,
+  "CV" /* Dinner */,
+  "MORN" /* Morning */,
+  "MORN.early" /* Early Morning */,
+  "MORN.late" /* Late Morning */,
+  "NOON" /* Noon */,
+  "AFT" /* Afternoon */,
+  "AFT.early" /* Early Afternoon */,
+  "AFT.late" /* Late Afternoon */,
+  "EVE" /* Evening */,
+  "EVE.early" /* Early Evening */,
+  "EVE.late" /* Late Evening */,
+  "NIGHT" /* Night */,
+  "WAKE" /* Wake */,
+  "PHS" /* After Sleep */
+]);
+function uniqueValues(values) {
+  const seen = /* @__PURE__ */ new Set();
+  const result = [];
+  for (const value of values) {
+    if (!seen.has(value)) {
+      seen.add(value);
+      result.push(value);
+    }
+  }
+  return result;
+}
+function getMealTimingGroup(when, options) {
+  if (!(options == null ? void 0 : options.groupMealTimingsByRelation)) {
+    return void 0;
+  }
+  const uniqueWhen2 = uniqueValues(when);
+  if (uniqueWhen2.length < 2) {
+    return void 0;
+  }
+  let relation;
+  const meals = [];
+  const groupedCodes = [];
+  let sawFirstMeal = false;
+  for (let i = 0; i < uniqueWhen2.length; i += 1) {
+    const code = uniqueWhen2[i];
+    const detail = MEAL_TIMING_DETAILS[code];
+    if (!detail) {
+      if (sawFirstMeal) {
+        break;
+      }
+      continue;
+    }
+    if (!sawFirstMeal) {
+      sawFirstMeal = true;
+    }
+    if (!relation) {
+      relation = detail.relation;
+    } else if (relation !== detail.relation && detail.relation !== "with") {
+      break;
+    }
+    meals.push(detail.meal);
+    groupedCodes.push(code);
+  }
+  if (groupedCodes.length < 2) {
+    return void 0;
+  }
+  for (let i = 1; i < meals.length; i += 1) {
+    const current = meals[i];
+    let j = i - 1;
+    while (j >= 0 && MEAL_ORDER[meals[j]] > MEAL_ORDER[current]) {
+      meals[j + 1] = meals[j];
+      j -= 1;
+    }
+    meals[j + 1] = current;
+  }
+  if (!relation) {
+    return void 0;
+  }
+  return {
+    relation,
+    meals,
+    codes: groupedCodes
+  };
+}
+function inferDailyOccurrenceCount(input, options) {
+  var _a2, _b, _c, _d;
+  if (!(options == null ? void 0 : options.includeTimesPerDaySummary)) {
+    return void 0;
+  }
+  if (input.frequency !== void 0 || input.frequencyMax !== void 0 || input.timingCode) {
+    return void 0;
+  }
+  if (input.period !== void 0 || input.periodMax !== void 0 || input.periodUnit !== void 0) {
+    return void 0;
+  }
+  if (((_b = (_a2 = input.dayOfWeek) == null ? void 0 : _a2.length) != null ? _b : 0) > 0) {
+    return void 0;
+  }
+  const uniqueWhen2 = uniqueValues((_c = input.when) != null ? _c : []);
+  for (let i = 0; i < uniqueWhen2.length; i += 1) {
+    if (!INFERABLE_DAILY_EVENT_TIMINGS.has(uniqueWhen2[i])) {
+      return void 0;
+    }
+  }
+  const uniqueTimes = uniqueValues((_d = input.timeOfDay) != null ? _d : []);
+  const occurrences = uniqueWhen2.length + uniqueTimes.length;
+  if (occurrences === 0) {
+    return void 0;
+  }
+  return occurrences;
+}
+
+// src/localized-timing.ts
+function uniqueWhenEvents(schedule) {
+  var _a2;
+  const when = (_a2 = schedule == null ? void 0 : schedule.when) != null ? _a2 : [];
+  if (!when.length) {
+    return [];
+  }
+  const unique = [];
+  const seen = /* @__PURE__ */ new Set();
+  for (const code of when) {
+    if (!seen.has(code)) {
+      seen.add(code);
+      unique.push(code);
+    }
+  }
+  return unique;
+}
+function filterLocalizedWhenEvents(schedule) {
+  const unique = uniqueWhenEvents(schedule);
+  const specificAfter = /* @__PURE__ */ new Set();
+  const specificBefore = /* @__PURE__ */ new Set();
+  const specificWith = /* @__PURE__ */ new Set();
+  for (const code of unique) {
+    if (code === "PCM" /* After Breakfast */ || code === "PCD" /* After Lunch */ || code === "PCV" /* After Dinner */) {
+      specificAfter.add(code);
+    }
+    if (code === "ACM" /* Before Breakfast */ || code === "ACD" /* Before Lunch */ || code === "ACV" /* Before Dinner */) {
+      specificBefore.add(code);
+    }
+    if (code === "CM" /* Breakfast */ || code === "CD" /* Lunch */ || code === "CV" /* Dinner */) {
+      specificWith.add(code);
+    }
+  }
+  const hasAllAfter = specificAfter.has("PCM" /* After Breakfast */) && specificAfter.has("PCD" /* After Lunch */) && specificAfter.has("PCV" /* After Dinner */);
+  const hasAllBefore = specificBefore.has("ACM" /* Before Breakfast */) && specificBefore.has("ACD" /* Before Lunch */) && specificBefore.has("ACV" /* Before Dinner */);
+  const hasAllWith = specificWith.has("CM" /* Breakfast */) && specificWith.has("CD" /* Lunch */) && specificWith.has("CV" /* Dinner */);
+  const filtered = [];
+  for (const code of unique) {
+    if (code === "PC" /* After Meal */ && hasAllAfter) {
+      continue;
+    }
+    if (code === "AC" /* Before Meal */ && hasAllBefore) {
+      continue;
+    }
+    if (code === "C" /* Meal */ && hasAllWith) {
+      continue;
+    }
+    filtered.push(code);
+  }
+  return filtered;
+}
+function collectLocalizedWhenPhrases(schedule, grammar, options) {
+  const filtered = filterLocalizedWhenEvents(schedule);
+  if (!filtered.length) {
+    return [];
+  }
+  const mealGroup = getMealTimingGroup(filtered, options);
+  if (!mealGroup) {
+    const phrases2 = [];
+    for (const code of filtered) {
+      const text = grammar.whenText[code];
+      if (text) {
+        phrases2.push(text);
+      }
+    }
+    return phrases2;
+  }
+  const groupedCodes = new Set(mealGroup.codes);
+  const phrases = [];
+  let insertedGroup = false;
+  for (const code of filtered) {
+    if (groupedCodes.has(code)) {
+      if (!insertedGroup) {
+        phrases.push(grammar.summarizeMealTimingGroup(mealGroup));
+        insertedGroup = true;
+      }
+      continue;
+    }
+    const text = grammar.whenText[code];
+    if (text) {
+      phrases.push(text);
+    }
+  }
+  return phrases;
+}
+function inferExplicitDailyFrequency(schedule) {
+  var _a2;
+  if (!schedule) {
+    return void 0;
+  }
+  if (schedule.frequency !== void 0 && schedule.frequencyMax === void 0 && schedule.periodUnit === "d" /* Day */ && (schedule.period === void 0 || schedule.period === 1) && schedule.periodMax === void 0) {
+    return schedule.frequency;
+  }
+  switch ((_a2 = schedule.timingCode) == null ? void 0 : _a2.toUpperCase()) {
+    case "QD":
+      return 1;
+    case "BID":
+      return 2;
+    case "TID":
+      return 3;
+    case "QID":
+      return 4;
+    default:
+      return void 0;
+  }
+}
+function isBedtimeOnlyWhen(schedule) {
+  const filtered = filterLocalizedWhenEvents(schedule);
+  return filtered.length === 1 && filtered[0] === "HS" /* Before Sleep */;
+}
+function combineLocalizedFrequencyAndEvents(schedule, frequency, events, grammar, options) {
+  var _a2, _b, _c;
+  if (!frequency) {
+    if (!events.length) {
+      return {};
+    }
+    return { event: grammar.joinList(events) };
+  }
+  if (!events.length) {
+    return { frequency };
+  }
+  if (events.length === 1 && isBedtimeOnlyWhen(schedule)) {
+    const dailyCount = (_a2 = inferExplicitDailyFrequency(schedule)) != null ? _a2 : inferDailyOccurrenceCount(schedule != null ? schedule : {}, options);
+    const style = (_c = (_b = grammar.bedtimeJoinStyle) == null ? void 0 : _b.call(grammar, dailyCount)) != null ? _c : "separate";
+    if (style === "adjacent") {
+      return { frequency: `${frequency} ${events[0]}` };
+    }
+    if (style === "conjunction") {
+      return { frequency: grammar.joinList([frequency, events[0]]) };
+    }
+  }
+  return { frequency, event: grammar.joinList(events) };
+}
+
+// src/prn.ts
+function getCanonicalPrnReasonText(reason) {
+  var _a2, _b;
+  return (_b = reason == null ? void 0 : reason.text) != null ? _b : (_a2 = reason == null ? void 0 : reason.coding) == null ? void 0 : _a2.display;
+}
+function joinCanonicalPrnReasonTexts(reasons, conjunction = "or") {
+  var _a2;
+  if (!(reasons == null ? void 0 : reasons.length)) {
+    return void 0;
+  }
+  const texts = [];
+  for (const reason of reasons) {
+    const text = (_a2 = getCanonicalPrnReasonText(reason)) == null ? void 0 : _a2.trim();
+    if (!text) {
+      continue;
+    }
+    texts.push(text);
+  }
+  switch (texts.length) {
+    case 0:
+      return void 0;
+    case 1:
+      return texts[0];
+    case 2:
+      return `${texts[0]} ${conjunction} ${texts[1]}`;
+    default: {
+      let combined = "";
+      for (let index = 0; index < texts.length; index += 1) {
+        if (index === 0) {
+          combined = texts[index];
+          continue;
+        }
+        if (index === texts.length - 1) {
+          combined += ` ${conjunction} ${texts[index]}`;
+          continue;
+        }
+        combined += `, ${texts[index]}`;
+      }
+      return combined;
+    }
+  }
+}
+function getPreferredCanonicalPrnReasonText(reason, reasons, conjunction = "or") {
+  var _a2;
+  const direct = (_a2 = getCanonicalPrnReasonText(reason)) == null ? void 0 : _a2.trim();
+  if (!(reasons == null ? void 0 : reasons.length)) {
+    return direct;
+  }
+  if (!direct) {
+    return joinCanonicalPrnReasonTexts(reasons, conjunction);
+  }
+  return /[,/;]/.test(direct) || /\b(?:or|and|and\/or)\b/i.test(direct) || /\s(?:หรือ|และ)\s/.test(direct) ? joinCanonicalPrnReasonTexts(reasons, conjunction) : direct;
+}
+
 // src/snomed.ts
 var SNOMED_SYSTEM = "http://snomed.info/sct";
 var SNOMED_CT_FINDING_SITE_ATTRIBUTE_CODE = "363698007";
@@ -497,8 +765,8 @@ function mergeTranslationPrimitiveElement(base, translations) {
     if (extension.url !== FHIR_TRANSLATION_EXTENSION_URL) {
       continue;
     }
-    const { locale } = getTranslationParts(extension);
-    if (locale) {
+    const { locale, content } = getTranslationParts(extension);
+    if (locale && content) {
       existingTranslationLocales.add(locale);
     }
   }
@@ -1167,10 +1435,11 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     }
   },
   {
-    names: ["both eyes", "bilateral eyes", "\u0E15\u0E32\u0E17\u0E31\u0E49\u0E07\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07", "\u0E15\u0E32\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07"],
+    names: ["both eyes", "bilateral eyes", "each eye", "\u0E15\u0E32\u0E17\u0E31\u0E49\u0E07\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07", "\u0E15\u0E32\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07"],
     definition: {
       coding: { code: "40638003", display: "Structure of both eyes" },
       text: "both eyes",
+      administrationTargetCount: 2,
       i18n: { th: "\u0E15\u0E32\u0E17\u0E31\u0E49\u0E07\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07" },
       routeHint: RouteCode["Ophthalmic route"]
     }
@@ -1184,10 +1453,19 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     }
   },
   {
-    names: ["ears", "both ears", "bilateral ears", "inside ears", "\u0E2B\u0E39\u0E17\u0E31\u0E49\u0E07\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07", "\u0E2B\u0E39\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07"],
+    names: [
+      "ears",
+      "both ears",
+      "bilateral ears",
+      "each ear",
+      "inside ears",
+      "\u0E2B\u0E39\u0E17\u0E31\u0E49\u0E07\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07",
+      "\u0E2B\u0E39\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07"
+    ],
     definition: {
       coding: { code: "34338003", display: "Both ears" },
       text: "both ears",
+      administrationTargetCount: 2,
       routeHint: RouteCode["Otic route"]
     }
   },
@@ -1205,10 +1483,18 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     }
   },
   {
-    names: ["ear canals", "both ear canals", "inside ear canals", "both external auditory canals"],
+    names: [
+      "ear canals",
+      "both ear canals",
+      "each ear canal",
+      "inside ear canals",
+      "both external auditory canals",
+      "each external auditory canal"
+    ],
     definition: {
       coding: { code: "181178004", display: "Entire external auditory canal" },
       text: "both ear canals",
+      administrationTargetCount: 2,
       routeHint: RouteCode["Otic route"]
     }
   },
@@ -1245,8 +1531,12 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     }
   },
   {
-    names: ["nostril", "nostrils"],
-    definition: { coding: { code: "1797002", display: "Naris" }, routeHint: RouteCode["Nasal route"] }
+    names: ["nostril"],
+    definition: {
+      coding: { code: "1797002", display: "Naris" },
+      text: "nostril",
+      routeHint: RouteCode["Nasal route"]
+    }
   },
   {
     names: ["left nostril", "left naris"],
@@ -1263,8 +1553,22 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     }
   },
   {
-    names: ["nares", "anterior nares"],
-    definition: { coding: { code: "244506005", display: "Anterior nares" }, routeHint: RouteCode["Nasal route"] }
+    names: [
+      "nostrils",
+      "both nostrils",
+      "bilateral nostrils",
+      "each nostril",
+      "nares",
+      "anterior nares",
+      "\u0E23\u0E39\u0E08\u0E21\u0E39\u0E01\u0E17\u0E31\u0E49\u0E07\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07"
+    ],
+    definition: {
+      coding: { code: "244506005", display: "Anterior nares" },
+      text: "both nostrils",
+      administrationTargetCount: 2,
+      i18n: { th: "\u0E23\u0E39\u0E08\u0E21\u0E39\u0E01\u0E17\u0E31\u0E49\u0E07\u0E2A\u0E2D\u0E07\u0E02\u0E49\u0E32\u0E07" },
+      routeHint: RouteCode["Nasal route"]
+    }
   },
   {
     names: ["nose"],
@@ -1790,6 +2094,24 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     names: ["affected area", "affected areas", "affected site", "\u0E1A\u0E23\u0E34\u0E40\u0E27\u0E13\u0E17\u0E35\u0E48\u0E40\u0E1B\u0E47\u0E19"],
     definition: { text: "affected area", routeHint: RouteCode["Topical route"] }
   },
+  {
+    names: ["lesion", "skin lesion"],
+    definition: {
+      coding: { code: "95324001", display: "Skin lesion" },
+      text: "lesion",
+      routeHint: RouteCode["Topical route"],
+      i18n: { th: "\u0E23\u0E2D\u0E22\u0E42\u0E23\u0E04" }
+    }
+  },
+  {
+    names: ["lesions", "skin lesions"],
+    definition: {
+      coding: { code: "95324001", display: "Skin lesion" },
+      text: "lesions",
+      routeHint: RouteCode["Topical route"],
+      i18n: { th: "\u0E23\u0E2D\u0E22\u0E42\u0E23\u0E04" }
+    }
+  },
   {
     names: ["left head", "left side of head"],
     definition: { coding: { code: "64237003", display: "Structure of left half of head" }, routeHint: RouteCode["Topical route"] }
@@ -1830,6 +2152,14 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     names: ["axilla", "axillae", "armpit", "armpits"],
     definition: { coding: { code: "34797008", display: "Axilla structure" }, routeHint: RouteCode["Topical route"] }
   },
+  {
+    names: ["axillary hair", "armpit hair", "armpit hairs", "underarm hair", "underarm hairs"],
+    definition: {
+      coding: { code: "75703003", display: "Structure of hair of axilla" },
+      text: "axillary hair",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
   {
     names: ["groin"],
     definition: { coding: { code: "26893007", display: "Inguinal region structure" }, routeHint: RouteCode["Topical route"] }
@@ -1900,6 +2230,71 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     names: ["face"],
     definition: { coding: { code: "89545001", display: "Face" }, routeHint: RouteCode["Topical route"] }
   },
+  {
+    names: ["eyebrow", "brow"],
+    definition: {
+      coding: { code: "392262008", display: "Eyebrow structure" },
+      text: "eyebrow",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["eyebrows", "brows"],
+    definition: {
+      coding: { code: "392262008", display: "Eyebrow structure" },
+      text: "eyebrows",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["left eyebrow", "left brow"],
+    definition: {
+      coding: { code: "722011002", display: "Structure of eyebrow of left eye region" },
+      text: "left eyebrow",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["right eyebrow", "right brow"],
+    definition: {
+      coding: { code: "722012009", display: "Structure of eyebrow of right eye region" },
+      text: "right eyebrow",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: [
+      "both eyebrows",
+      "bilateral eyebrows",
+      "each eyebrow",
+      "left and right eyebrow",
+      "left and right eyebrows",
+      "right and left eyebrow",
+      "right and left eyebrows",
+      "left right eyebrow",
+      "left right eyebrows"
+    ],
+    definition: {
+      coding: {
+        code: buildSnomedBodySiteLateralityPostcoordinationCode(
+          "392262008",
+          SNOMED_CT_BILATERAL_QUALIFIER_CODE
+        ),
+        display: "both eyebrows"
+      },
+      text: "both eyebrows",
+      administrationTargetCount: 2,
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["eyebrow hair", "eyebrow hairs", "brow hair", "brow hairs"],
+    definition: {
+      coding: { code: "392261001", display: "Hair structure of eyebrow" },
+      text: "eyebrow hair",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
   {
     names: ["eyelid", "eyelids"],
     definition: { coding: { code: "80243003", display: "Eyelid" }, routeHint: RouteCode["Ophthalmic route"] }
@@ -2020,14 +2415,70 @@ var DEFAULT_BODY_SITE_SNOMED_SOURCE = [
     names: ["perineum"],
     definition: { coding: { code: "243990009", display: "Entire perineum" }, routeHint: RouteCode["Topical route"] }
   },
+  {
+    names: ["mustache", "moustache", "mustache hair", "moustache hair"],
+    definition: {
+      coding: { code: "256925006", display: "Structure of hair of mustache" },
+      text: "mustache",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["beard", "beard hair", "facial hair"],
+    definition: {
+      coding: { code: "367576007", display: "Structure of beard hair" },
+      text: "beard",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["pubic hair"],
+    definition: {
+      coding: { code: "75776007", display: "Structure of hair of pubis" },
+      text: "pubic hair",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
   {
     names: ["skin"],
     definition: { coding: { code: "181469002", display: "Entire skin" }, routeHint: RouteCode["Topical route"] }
   },
   {
-    names: ["hair"],
+    names: ["hair"],
+    definition: {
+      coding: { code: "386045008", display: "Hair structure (body structure)" },
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["joint"],
+    definition: {
+      coding: { code: "39352004", display: "Joint structure" },
+      text: "joint",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["joints"],
+    definition: {
+      coding: { code: "81087007", display: "Joints" },
+      text: "joints",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["finger joint", "finger joints"],
+    definition: {
+      coding: { code: "125682004", display: "Finger joint structure" },
+      text: "finger joints",
+      routeHint: RouteCode["Topical route"]
+    }
+  },
+  {
+    names: ["knuckle", "knuckles"],
     definition: {
-      coding: { code: "386045008", display: "Hair structure (body structure)" },
+      coding: { code: "70420003", display: "Metacarpophalangeal joint structure" },
+      text: "knuckles",
       routeHint: RouteCode["Topical route"]
     }
   }
@@ -3941,6 +4392,7 @@ var lexical_classes_default = {
     "Use shampoo": "\u0E2A\u0E23\u0E30"
   },
   compoundDoseUnits: [
+    { head: "cm", tails: [], requiresSiteContext: true, unit: "cm line" },
     { head: "cm", tails: ["ribbon", "ribbons"], unit: "cm ribbon" },
     { head: "cm", tails: ["strip", "strips"], unit: "cm strip" },
     { head: "cm", tails: ["line", "lines"], unit: "cm line" },
@@ -3949,6 +4401,8 @@ var lexical_classes_default = {
     { head: "fingertip", tails: ["unit", "units"], unit: "FTU" },
     { head: "eye", tails: ["drop", "drops"], unit: "drop" },
     { head: "pea-sized", tails: ["amount"], unit: "pea-sized amount" },
+    { head: "pea-size", tails: ["amount"], unit: "pea-sized amount" },
+    { head: "peasize", tails: [], tailSequences: [[]], unit: "pea-sized amount" },
     { head: "\u0E40\u0E21\u0E47\u0E14\u0E16\u0E31\u0E48\u0E27", tails: [], unit: "pea-sized amount" },
     { head: "\u0E40\u0E21\u0E47\u0E14\u0E16\u0E31\u0E48\u0E27\u0E40\u0E02\u0E35\u0E22\u0E27", tails: [], unit: "pea-sized amount" },
     { head: "\u0E40\u0E21\u0E25\u0E47\u0E14\u0E16\u0E31\u0E48\u0E27", tails: [], unit: "pea-sized amount" },
@@ -3958,7 +4412,7 @@ var lexical_classes_default = {
     {
       head: "pea",
       tails: [],
-      tailSequences: [["sized", "amount"], ["size", "amount"]],
+      tailSequences: [["sized", "amount"], ["size", "amount"], ["amount"], ["sized"], ["size"], []],
       unit: "pea-sized amount"
     },
     { head: "hand", tails: ["print", "prints"], unit: "handprint" },
@@ -4369,6 +4823,7 @@ var BODY_SITE_FEATURE_SCORE_BONUS = bodySiteFeatureScoreBonus(lexical_classes_de
 var CONNECTORS = setOf(lexical_classes_default.connectors);
 var ROUTE_SITE_PREPOSITIONS = setOf(lexical_classes_default.routeSitePrepositions);
 var SITE_DISPLAY_FILLERS = SITE_FILLERS;
+var SITE_MULTIPLICITY_WORDS = setOf(["both", "each", "bilateral"]);
 var NON_SITE_ANCHORED_PHRASES = setOf(lexical_classes_default.nonSiteAnchoredPhrases);
 var EXTERNAL_SITE_LOCATIVE_PREFIXES = setOf(lexical_classes_default.externalSiteLocativePrefixes);
 var ROUTE_BLOCKED_BY_FOLLOWING_PARTITIVE_HEADS = setOf(
@@ -4914,140 +5369,6 @@ function resolveBodySitePhrase(text, customSiteMap, context) {
   };
 }
 
-// src/timing-summary.ts
-var MEAL_TIMING_DETAILS = {
-  ["ACM" /* Before Breakfast */]: { relation: "before", meal: "breakfast" },
-  ["ACD" /* Before Lunch */]: { relation: "before", meal: "lunch" },
-  ["ACV" /* Before Dinner */]: { relation: "before", meal: "dinner" },
-  ["PCM" /* After Breakfast */]: { relation: "after", meal: "breakfast" },
-  ["PCD" /* After Lunch */]: { relation: "after", meal: "lunch" },
-  ["PCV" /* After Dinner */]: { relation: "after", meal: "dinner" },
-  ["CM" /* Breakfast */]: { relation: "with", meal: "breakfast" },
-  ["CD" /* Lunch */]: { relation: "with", meal: "lunch" },
-  ["CV" /* Dinner */]: { relation: "with", meal: "dinner" }
-};
-var MEAL_ORDER = {
-  breakfast: 0,
-  lunch: 1,
-  dinner: 2
-};
-var INFERABLE_DAILY_EVENT_TIMINGS = /* @__PURE__ */ new Set([
-  "HS" /* Before Sleep */,
-  "ACM" /* Before Breakfast */,
-  "ACD" /* Before Lunch */,
-  "ACV" /* Before Dinner */,
-  "PCM" /* After Breakfast */,
-  "PCD" /* After Lunch */,
-  "PCV" /* After Dinner */,
-  "CM" /* Breakfast */,
-  "CD" /* Lunch */,
-  "CV" /* Dinner */,
-  "MORN" /* Morning */,
-  "MORN.early" /* Early Morning */,
-  "MORN.late" /* Late Morning */,
-  "NOON" /* Noon */,
-  "AFT" /* Afternoon */,
-  "AFT.early" /* Early Afternoon */,
-  "AFT.late" /* Late Afternoon */,
-  "EVE" /* Evening */,
-  "EVE.early" /* Early Evening */,
-  "EVE.late" /* Late Evening */,
-  "NIGHT" /* Night */,
-  "WAKE" /* Wake */,
-  "PHS" /* After Sleep */
-]);
-function uniqueValues(values) {
-  const seen = /* @__PURE__ */ new Set();
-  const result = [];
-  for (const value of values) {
-    if (!seen.has(value)) {
-      seen.add(value);
-      result.push(value);
-    }
-  }
-  return result;
-}
-function getMealTimingGroup(when, options) {
-  if (!(options == null ? void 0 : options.groupMealTimingsByRelation)) {
-    return void 0;
-  }
-  const uniqueWhen2 = uniqueValues(when);
-  if (uniqueWhen2.length < 2) {
-    return void 0;
-  }
-  let relation;
-  const meals = [];
-  const groupedCodes = [];
-  let sawFirstMeal = false;
-  for (let i = 0; i < uniqueWhen2.length; i += 1) {
-    const code = uniqueWhen2[i];
-    const detail = MEAL_TIMING_DETAILS[code];
-    if (!detail) {
-      if (sawFirstMeal) {
-        break;
-      }
-      continue;
-    }
-    if (!sawFirstMeal) {
-      sawFirstMeal = true;
-    }
-    if (!relation) {
-      relation = detail.relation;
-    } else if (relation !== detail.relation && detail.relation !== "with") {
-      break;
-    }
-    meals.push(detail.meal);
-    groupedCodes.push(code);
-  }
-  if (groupedCodes.length < 2) {
-    return void 0;
-  }
-  for (let i = 1; i < meals.length; i += 1) {
-    const current = meals[i];
-    let j = i - 1;
-    while (j >= 0 && MEAL_ORDER[meals[j]] > MEAL_ORDER[current]) {
-      meals[j + 1] = meals[j];
-      j -= 1;
-    }
-    meals[j + 1] = current;
-  }
-  if (!relation) {
-    return void 0;
-  }
-  return {
-    relation,
-    meals,
-    codes: groupedCodes
-  };
-}
-function inferDailyOccurrenceCount(input, options) {
-  var _a2, _b, _c, _d;
-  if (!(options == null ? void 0 : options.includeTimesPerDaySummary)) {
-    return void 0;
-  }
-  if (input.frequency !== void 0 || input.frequencyMax !== void 0 || input.timingCode) {
-    return void 0;
-  }
-  if (input.period !== void 0 || input.periodMax !== void 0 || input.periodUnit !== void 0) {
-    return void 0;
-  }
-  if (((_b = (_a2 = input.dayOfWeek) == null ? void 0 : _a2.length) != null ? _b : 0) > 0) {
-    return void 0;
-  }
-  const uniqueWhen2 = uniqueValues((_c = input.when) != null ? _c : []);
-  for (let i = 0; i < uniqueWhen2.length; i += 1) {
-    if (!INFERABLE_DAILY_EVENT_TIMINGS.has(uniqueWhen2[i])) {
-      return void 0;
-    }
-  }
-  const uniqueTimes = uniqueValues((_d = input.timeOfDay) != null ? _d : []);
-  const occurrences = uniqueWhen2.length + uniqueTimes.length;
-  if (occurrences === 0) {
-    return void 0;
-  }
-  return occurrences;
-}
-
 // src/format.ts
 var ROUTE_SHORT = {
   [RouteCode["Oral route"]]: "PO",
@@ -5539,73 +5860,22 @@ function summarizeMealTimingGroup(group) {
   }
   return `${relationText} ${joinWithAnd(group.meals)}`;
 }
-function collectWhenPhrases(schedule, options) {
-  var _a2, _b, _c;
-  const when = (_a2 = schedule == null ? void 0 : schedule.when) != null ? _a2 : [];
-  if (!when.length) {
-    return [];
-  }
-  const unique = [];
-  const seen = /* @__PURE__ */ new Set();
-  let hasSpecificAfter = false;
-  let hasSpecificBefore = false;
-  let hasSpecificWith = false;
-  for (const code of when) {
-    if (!seen.has(code)) {
-      seen.add(code);
-      unique.push(code);
-      if (code === "PCM" /* After Breakfast */ || code === "PCD" /* After Lunch */ || code === "PCV" /* After Dinner */) {
-        hasSpecificAfter = true;
-      }
-      if (code === "ACM" /* Before Breakfast */ || code === "ACD" /* Before Lunch */ || code === "ACV" /* Before Dinner */) {
-        hasSpecificBefore = true;
-      }
-      if (code === "CM" /* Breakfast */ || code === "CD" /* Lunch */ || code === "CV" /* Dinner */) {
-        hasSpecificWith = true;
-      }
-    }
-  }
-  const filtered = [];
-  for (const code of unique) {
-    if (code === "PC" /* After Meal */ && hasSpecificAfter) {
-      continue;
-    }
-    if (code === "AC" /* Before Meal */ && hasSpecificBefore) {
-      continue;
-    }
-    if (code === "C" /* Meal */ && hasSpecificWith) {
-      continue;
-    }
-    filtered.push(code);
-  }
-  const mealGroup = getMealTimingGroup(filtered, options);
-  if (!mealGroup) {
-    const phrases2 = [];
-    for (const code of filtered) {
-      const text = (_b = WHEN_TEXT[code]) != null ? _b : code;
-      if (text) {
-        phrases2.push(text);
-      }
-    }
-    return phrases2;
-  }
-  const groupedCodes = new Set(mealGroup.codes);
-  const phrases = [];
-  let insertedGroup = false;
-  for (const code of filtered) {
-    if (groupedCodes.has(code)) {
-      if (!insertedGroup) {
-        phrases.push(summarizeMealTimingGroup(mealGroup));
-        insertedGroup = true;
-      }
-      continue;
+var EN_TIMING_GRAMMAR = {
+  whenText: WHEN_TEXT,
+  joinList: joinWithAnd,
+  summarizeMealTimingGroup,
+  bedtimeJoinStyle: (dailyCount) => {
+    if (dailyCount === 1) {
+      return "adjacent";
     }
-    const text = (_c = WHEN_TEXT[code]) != null ? _c : code;
-    if (text) {
-      phrases.push(text);
+    if (dailyCount === 2 || dailyCount === 3 || dailyCount === 4) {
+      return "conjunction";
     }
+    return "separate";
   }
-  return phrases;
+};
+function collectWhenPhrases(schedule, options) {
+  return collectLocalizedWhenPhrases(schedule, EN_TIMING_GRAMMAR, options);
 }
 function joinWithAnd(parts) {
   if (!parts.length) {
@@ -5619,23 +5889,14 @@ function joinWithAnd(parts) {
   }
   return `${parts.slice(0, -1).join(", ")} and ${parts[parts.length - 1]}`;
 }
-function combineFrequencyAndEvents(frequency, events) {
-  if (!frequency) {
-    if (!events.length) {
-      return {};
-    }
-    return { event: joinWithAnd(events) };
-  }
-  if (!events.length) {
-    return { frequency };
-  }
-  if (events.length === 1 && events[0] === "at bedtime") {
-    const lowerFrequency = frequency.toLowerCase();
-    if (lowerFrequency === "twice daily" || lowerFrequency === "three times daily" || lowerFrequency === "four times daily") {
-      return { frequency: `${frequency} and ${events[0]}` };
-    }
-  }
-  return { frequency, event: joinWithAnd(events) };
+function combineFrequencyAndEvents(schedule, frequency, events, options) {
+  return combineLocalizedFrequencyAndEvents(
+    schedule,
+    frequency,
+    events,
+    EN_TIMING_GRAMMAR,
+    options
+  );
 }
 function buildRoutePhrase(clause, grammar, hasSite) {
   var _a2, _b;
@@ -5940,7 +6201,7 @@ function formatLong(clause, options) {
       eventParts.push(`at ${timeStrings.join(", ")}`);
     }
   }
-  const timing = combineFrequencyAndEvents(frequencyPart, eventParts);
+  const timing = combineFrequencyAndEvents(schedule, frequencyPart, eventParts, options);
   const dayPart = describeDayOfWeek(schedule);
   const countPart = schedule.count !== void 0 && !standaloneOccurrenceCount ? `for ${stripTrailingZero(schedule.count)} ${schedule.count === 1 ? "dose" : "doses"}` : void 0;
   const durationPart = describeDuration(schedule);
@@ -9735,6 +9996,81 @@ function listSupportedBodySiteGrammar() {
   };
 }
 
+// src/body-site-target.ts
+var BODY_SITE_ADMINISTRATION_TARGET_COUNT_EXTENSION_URL = "urn:ezmedicationinput:body-site-administration-target-count";
+function normalizeAdministrationTargetCount(value) {
+  if (!Number.isFinite(value) || value === void 0) {
+    return void 0;
+  }
+  const rounded = Math.trunc(value);
+  return rounded >= 2 ? rounded : void 0;
+}
+function siteTextFromLike(site, options) {
+  if (!site) {
+    return void 0;
+  }
+  if (typeof site === "string") {
+    return site;
+  }
+  if ("text" in site && site.text) {
+    return site.text;
+  }
+  const coding = "coding" in site ? Array.isArray(site.coding) ? site.coding.find((candidate) => candidate == null ? void 0 : candidate.code) : site.coding : void 0;
+  return (coding == null ? void 0 : coding.code) ? getBodySiteText(
+    {
+      system: coding.system,
+      code: coding.code,
+      display: coding.display
+    },
+    { siteCodeMap: options == null ? void 0 : options.siteCodeMap }
+  ) : void 0;
+}
+function buildBodySiteAdministrationTargetCountExtension(targetCount) {
+  const normalized = normalizeAdministrationTargetCount(targetCount);
+  if (normalized === void 0) {
+    return void 0;
+  }
+  return {
+    url: BODY_SITE_ADMINISTRATION_TARGET_COUNT_EXTENSION_URL,
+    valueInteger: normalized
+  };
+}
+function parseBodySiteAdministrationTargetCountExtension(concept) {
+  var _a2;
+  const extension = (_a2 = concept == null ? void 0 : concept.extension) == null ? void 0 : _a2.find(
+    (candidate) => candidate.url === BODY_SITE_ADMINISTRATION_TARGET_COUNT_EXTENSION_URL
+  );
+  return normalizeAdministrationTargetCount(extension == null ? void 0 : extension.valueInteger);
+}
+function getBodySiteAdministrationTargetCount(site, options) {
+  var _a2;
+  if (!site) {
+    return void 0;
+  }
+  if (typeof site !== "string" && "administrationTargetCount" in site) {
+    const direct = normalizeAdministrationTargetCount(site.administrationTargetCount);
+    if (direct !== void 0) {
+      return direct;
+    }
+  }
+  if (typeof site !== "string") {
+    if ("extension" in site) {
+      const fromExtension = parseBodySiteAdministrationTargetCountExtension(site);
+      if (fromExtension !== void 0) {
+        return fromExtension;
+      }
+    }
+  }
+  const text = siteTextFromLike(site, options);
+  if (!text) {
+    return void 0;
+  }
+  const resolved = resolveBodySitePhrase(text, options == null ? void 0 : options.siteCodeMap, {
+    bodySiteContext: options == null ? void 0 : options.bodySiteContext
+  });
+  return normalizeAdministrationTargetCount((_a2 = resolved == null ? void 0 : resolved.definition) == null ? void 0 : _a2.administrationTargetCount);
+}
+
 // src/parser-state.ts
 var ParserState = class {
   constructor(input, tokens, customSiteHints) {
@@ -10105,6 +10441,20 @@ var ParserState = class {
       sourceText: value.sourceText
     };
   }
+  get siteAdministrationTargetCount() {
+    var _a2;
+    return (_a2 = this.clause.site) == null ? void 0 : _a2.administrationTargetCount;
+  }
+  set siteAdministrationTargetCount(value) {
+    if (value === void 0) {
+      if (this.clause.site) {
+        delete this.clause.site.administrationTargetCount;
+        this.cleanupSite();
+      }
+      return;
+    }
+    this.ensureSite().administrationTargetCount = value;
+  }
   get additionalInstructions() {
     if (!this.clause.additionalInstructions) {
       this.clause.additionalInstructions = [];
@@ -10177,7 +10527,7 @@ var ParserState = class {
     if (!site) {
       return;
     }
-    if (site.text === void 0 && site.coding === void 0 && site.spatialRelation === void 0 && site.source === void 0 && site.inferred === void 0 && site.evidence === void 0) {
+    if (site.text === void 0 && site.coding === void 0 && site.spatialRelation === void 0 && site.administrationTargetCount === void 0 && site.source === void 0 && site.inferred === void 0 && site.evidence === void 0) {
       delete this.clause.site;
     }
   }
@@ -10538,7 +10888,7 @@ function appendWarning(warnings, warning) {
   return warnings;
 }
 function canonicalToFhir(clause, textOverride, options) {
-  var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o, _p, _q, _r, _s, _t, _u, _v, _w, _x, _y, _z, _A, _B, _C, _D, _E, _F, _G, _H, _I, _J;
+  var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o, _p, _q, _r, _s, _t, _u, _v, _w, _x, _y, _z, _A, _B, _C, _D, _E, _F, _G, _H, _I, _J, _K, _L, _M, _N;
   const dosage = {};
   const repeat = {};
   let hasRepeat = false;
@@ -10639,20 +10989,35 @@ function canonicalToFhir(clause, textOverride, options) {
   if (((_l = clause.site) == null ? void 0 : _l.text) || ((_n = (_m = clause.site) == null ? void 0 : _m.coding) == null ? void 0 : _n.code) || ((_o = clause.site) == null ? void 0 : _o.spatialRelation)) {
     const siteCoding = selectCanonicalSiteCoding(clause.site, options);
     const siteTextElement = (options == null ? void 0 : options.includeTranslationExtensions) ? buildTranslationPrimitiveElement((_p = clause.site.i18n) != null ? _p : siteCoding == null ? void 0 : siteCoding.i18n) : void 0;
+    const siteTargetCount = (_r = (_q = clause.site) == null ? void 0 : _q.administrationTargetCount) != null ? _r : getBodySiteAdministrationTargetCount(clause.site);
+    const inferredSiteTargetCount = getBodySiteAdministrationTargetCount({
+      text: (_s = clause.site) == null ? void 0 : _s.text,
+      coding: siteCoding ? {
+        code: siteCoding.code,
+        display: siteCoding.display,
+        system: siteCoding.system,
+        i18n: siteCoding.i18n
+      } : void 0
+    });
+    const siteTargetCountExtension = siteTargetCount !== void 0 && siteTargetCount !== inferredSiteTargetCount ? buildBodySiteAdministrationTargetCountExtension(siteTargetCount) : void 0;
+    const siteExtensions = [
+      ...(_u = buildBodySiteSpatialRelationExtensions((_t = clause.site) == null ? void 0 : _t.spatialRelation)) != null ? _u : [],
+      ...siteTargetCountExtension ? [siteTargetCountExtension] : []
+    ];
     dosage.site = __spreadProps(__spreadValues({
-      text: (_q = clause.site) == null ? void 0 : _q.text
+      text: (_v = clause.site) == null ? void 0 : _v.text
     }, siteTextElement ? { _text: siteTextElement } : {}), {
       coding: buildSiteCodingArray(siteCoding, options),
-      extension: buildBodySiteSpatialRelationExtensions((_r = clause.site) == null ? void 0 : _r.spatialRelation)
+      extension: siteExtensions.length ? siteExtensions : void 0
     });
   }
-  if (((_s = clause.method) == null ? void 0 : _s.text) || ((_t = clause.method) == null ? void 0 : _t._text) || ((_v = (_u = clause.method) == null ? void 0 : _u.coding) == null ? void 0 : _v.code)) {
+  if (((_w = clause.method) == null ? void 0 : _w.text) || ((_x = clause.method) == null ? void 0 : _x._text) || ((_z = (_y = clause.method) == null ? void 0 : _y.coding) == null ? void 0 : _z.code)) {
     dosage.method = {
-      text: (_w = clause.method) == null ? void 0 : _w.text,
-      _text: clonePrimitiveElement((_x = clause.method) == null ? void 0 : _x._text),
-      coding: ((_z = (_y = clause.method) == null ? void 0 : _y.coding) == null ? void 0 : _z.code) ? [
+      text: (_A = clause.method) == null ? void 0 : _A.text,
+      _text: clonePrimitiveElement((_B = clause.method) == null ? void 0 : _B._text),
+      coding: ((_D = (_C = clause.method) == null ? void 0 : _C.coding) == null ? void 0 : _D.code) ? [
         {
-          system: (_A = clause.method.coding.system) != null ? _A : SNOMED_SYSTEM5,
+          system: (_E = clause.method.coding.system) != null ? _E : SNOMED_SYSTEM5,
           code: clause.method.coding.code,
           display: clause.method.coding.display,
           _display: clonePrimitiveElement(clause.method.coding._display)
@@ -10660,14 +11025,14 @@ function canonicalToFhir(clause, textOverride, options) {
       ] : void 0
     };
   }
-  if ((_B = clause.additionalInstructions) == null ? void 0 : _B.length) {
+  if ((_F = clause.additionalInstructions) == null ? void 0 : _F.length) {
     dosage.additionalInstruction = [];
     for (const instruction of clause.additionalInstructions) {
       dosage.additionalInstruction.push({
         text: instruction.text,
-        coding: ((_C = instruction.coding) == null ? void 0 : _C.code) ? [
+        coding: ((_G = instruction.coding) == null ? void 0 : _G.code) ? [
           {
-            system: (_D = instruction.coding.system) != null ? _D : SNOMED_SYSTEM5,
+            system: (_H = instruction.coding.system) != null ? _H : SNOMED_SYSTEM5,
             code: instruction.coding.code,
             display: instruction.coding.display
           }
@@ -10675,9 +11040,9 @@ function canonicalToFhir(clause, textOverride, options) {
       });
     }
   }
-  if ((_E = clause.prn) == null ? void 0 : _E.enabled) {
+  if ((_I = clause.prn) == null ? void 0 : _I.enabled) {
     dosage.asNeededBoolean = true;
-    const reasons = ((_F = clause.prn.reasons) == null ? void 0 : _F.length) ? clause.prn.reasons : clause.prn.reason ? [clause.prn.reason] : [];
+    const reasons = ((_J = clause.prn.reasons) == null ? void 0 : _J.length) ? clause.prn.reasons : clause.prn.reason ? [clause.prn.reason] : [];
     if (reasons.length) {
       dosage.asNeededFor = [];
       for (const reason of reasons) {
@@ -10685,18 +11050,18 @@ function canonicalToFhir(clause, textOverride, options) {
         if (reason.text) {
           concept.text = reason.text;
         }
-        const reasonTextElement = (options == null ? void 0 : options.includeTranslationExtensions) ? buildTranslationPrimitiveElement((_H = reason.i18n) != null ? _H : (_G = reason.coding) == null ? void 0 : _G.i18n) : void 0;
+        const reasonTextElement = (options == null ? void 0 : options.includeTranslationExtensions) ? buildTranslationPrimitiveElement((_L = reason.i18n) != null ? _L : (_K = reason.coding) == null ? void 0 : _K.i18n) : void 0;
         if (reasonTextElement) {
           concept._text = reasonTextElement;
         }
-        if ((_I = reason.coding) == null ? void 0 : _I.code) {
+        if ((_M = reason.coding) == null ? void 0 : _M.code) {
           const displayElement = (options == null ? void 0 : options.includeTranslationExtensions) ? mergeTranslationPrimitiveElement(
             reason.coding._display,
             reason.coding.i18n
           ) : clonePrimitiveElement(reason.coding._display);
           concept.coding = [
             __spreadProps(__spreadValues({
-              system: (_J = reason.coding.system) != null ? _J : SNOMED_SYSTEM5,
+              system: (_N = reason.coding.system) != null ? _N : SNOMED_SYSTEM5,
               code: reason.coding.code,
               display: reason.coding.display
             }, displayElement ? { _display: displayElement } : {}), {
@@ -10737,11 +11102,13 @@ function canonicalFromFhir(dosage) {
   const siteSpatialRelation = parseBodySiteSpatialRelationExtension(dosage.site);
   const siteText = getFallbackSiteText(dosage.site);
   const siteI18n = codeableConceptTranslationI18n(dosage.site, siteCoding);
-  if (siteText || (siteCoding == null ? void 0 : siteCoding.code) || siteSpatialRelation) {
+  const siteAdministrationTargetCount = getBodySiteAdministrationTargetCount(dosage.site);
+  if (siteText || (siteCoding == null ? void 0 : siteCoding.code) || siteSpatialRelation || siteAdministrationTargetCount !== void 0) {
     clause.site = {
       text: siteText,
       i18n: siteI18n.text,
       spatialRelation: siteSpatialRelation,
+      administrationTargetCount: siteAdministrationTargetCount,
       coding: (siteCoding == null ? void 0 : siteCoding.code) ? {
         code: siteCoding.code,
         display: siteCoding.display,
@@ -11822,73 +12189,22 @@ function summarizeMealTimingGroupThai(group) {
   }
   return `${relationText[group.relation]}${joinMealNamesThai(meals)}`;
 }
-function collectWhenPhrasesThai(schedule, options) {
-  var _a2;
-  const when = (_a2 = schedule == null ? void 0 : schedule.when) != null ? _a2 : [];
-  if (!when.length) {
-    return [];
-  }
-  const unique = [];
-  const seen = /* @__PURE__ */ new Set();
-  let hasSpecificAfter = false;
-  let hasSpecificBefore = false;
-  let hasSpecificWith = false;
-  for (const code of when) {
-    if (!seen.has(code)) {
-      seen.add(code);
-      unique.push(code);
-      if (code === "PCM" /* After Breakfast */ || code === "PCD" /* After Lunch */ || code === "PCV" /* After Dinner */) {
-        hasSpecificAfter = true;
-      }
-      if (code === "ACM" /* Before Breakfast */ || code === "ACD" /* Before Lunch */ || code === "ACV" /* Before Dinner */) {
-        hasSpecificBefore = true;
-      }
-      if (code === "CM" /* Breakfast */ || code === "CD" /* Lunch */ || code === "CV" /* Dinner */) {
-        hasSpecificWith = true;
-      }
-    }
-  }
-  const filtered = [];
-  for (const code of unique) {
-    if (code === "PC" /* After Meal */ && hasSpecificAfter) {
-      continue;
-    }
-    if (code === "AC" /* Before Meal */ && hasSpecificBefore) {
-      continue;
-    }
-    if (code === "C" /* Meal */ && hasSpecificWith) {
-      continue;
-    }
-    filtered.push(code);
-  }
-  const mealGroup = getMealTimingGroup(filtered, options);
-  if (!mealGroup) {
-    const phrases2 = [];
-    for (const code of filtered) {
-      const text = WHEN_TEXT_THAI[code];
-      if (text) {
-        phrases2.push(text);
-      }
-    }
-    return phrases2;
-  }
-  const groupedCodes = new Set(mealGroup.codes);
-  const phrases = [];
-  let insertedGroup = false;
-  for (const code of filtered) {
-    if (groupedCodes.has(code)) {
-      if (!insertedGroup) {
-        phrases.push(summarizeMealTimingGroupThai(mealGroup));
-        insertedGroup = true;
-      }
-      continue;
+var TH_TIMING_GRAMMAR = {
+  whenText: WHEN_TEXT_THAI,
+  joinList: joinWithAndThai,
+  summarizeMealTimingGroup: summarizeMealTimingGroupThai,
+  bedtimeJoinStyle: (dailyCount) => {
+    if (dailyCount === 1) {
+      return "adjacent";
     }
-    const text = WHEN_TEXT_THAI[code];
-    if (text) {
-      phrases.push(text);
+    if (dailyCount === 2 || dailyCount === 3 || dailyCount === 4) {
+      return "conjunction";
     }
+    return "separate";
   }
-  return phrases;
+};
+function collectWhenPhrasesThai(schedule, options) {
+  return collectLocalizedWhenPhrases(schedule, TH_TIMING_GRAMMAR, options);
 }
 function joinWithAndThai(parts) {
   if (!parts.length) {
@@ -11902,20 +12218,14 @@ function joinWithAndThai(parts) {
   }
   return `${parts.slice(0, -1).join(", ")} \u0E41\u0E25\u0E30 ${parts[parts.length - 1]}`;
 }
-function combineFrequencyAndEventsThai(frequency, events) {
-  if (!frequency) {
-    if (!events.length) {
-      return {};
-    }
-    return { event: joinWithAndThai(events) };
-  }
-  if (!events.length) {
-    return { frequency };
-  }
-  if (events.length === 1 && events[0] === "\u0E01\u0E48\u0E2D\u0E19\u0E19\u0E2D\u0E19" && frequency.includes("\u0E27\u0E31\u0E19\u0E25\u0E30")) {
-    return { frequency: `${frequency} \u0E41\u0E25\u0E30 ${events[0]}` };
-  }
-  return { frequency, event: joinWithAndThai(events) };
+function combineFrequencyAndEventsThai(schedule, frequency, events, options) {
+  return combineLocalizedFrequencyAndEvents(
+    schedule,
+    frequency,
+    events,
+    TH_TIMING_GRAMMAR,
+    options
+  );
 }
 function isOralRouteThai(clause) {
   var _a2, _b, _c;
@@ -11974,7 +12284,7 @@ function buildRoutePhraseThai(clause, grammar, hasSite) {
   return text;
 }
 function formatSiteThai(clause, grammar) {
-  var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o;
+  var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o, _p, _q, _r, _s, _t, _u, _v;
   const text = ((_b = (_a2 = clause.site) == null ? void 0 : _a2.text) == null ? void 0 : _b.trim()) || ((_e = (_d = (_c = clause.site) == null ? void 0 : _c.coding) == null ? void 0 : _d.display) == null ? void 0 : _e.trim());
   const lower = text == null ? void 0 : text.toLowerCase();
   const codingCode = (_g = (_f = clause.site) == null ? void 0 : _f.coding) == null ? void 0 : _g.code;
@@ -11989,14 +12299,14 @@ function formatSiteThai(clause, grammar) {
   if (isVaginalRoute && isVaginaSite) {
     return void 0;
   }
-  const translated = text ? translateSiteThai(text, codingCode, (_l = clause.site) == null ? void 0 : _l.spatialRelation) : translateSpatialSiteThai(void 0, (_m = clause.site) == null ? void 0 : _m.spatialRelation);
+  const translated = (_t = (_q = (_m = (_l = clause.site) == null ? void 0 : _l.i18n) == null ? void 0 : _m.th) != null ? _q : (_p = (_o = (_n = clause.site) == null ? void 0 : _n.coding) == null ? void 0 : _o.i18n) == null ? void 0 : _p.th) != null ? _t : text ? translateSiteThai(text, codingCode, (_r = clause.site) == null ? void 0 : _r.spatialRelation) : translateSpatialSiteThai(void 0, (_s = clause.site) == null ? void 0 : _s.spatialRelation);
   if (!translated) {
     return void 0;
   }
-  if (((_n = clause.route) == null ? void 0 : _n.code) === RouteCode["Nasal route"]) {
+  if (((_u = clause.route) == null ? void 0 : _u.code) === RouteCode["Nasal route"]) {
     return `\u0E40\u0E02\u0E49\u0E32${translated}`;
   }
-  const preposition = (_o = grammar.sitePreposition) != null ? _o : "\u0E17\u0E35\u0E48";
+  const preposition = (_v = grammar.sitePreposition) != null ? _v : "\u0E17\u0E35\u0E48";
   const separator = /^[\u0E00-\u0E7F]/.test(translated) ? "" : " ";
   return `${preposition}${separator}${translated}`.trim();
 }
@@ -12294,7 +12604,7 @@ function formatLongThai(clause, options) {
       eventParts.push(`\u0E40\u0E27\u0E25\u0E32 ${timeStrings.join(", ")}`);
     }
   }
-  const timing = combineFrequencyAndEventsThai(frequencyPart, eventParts);
+  const timing = combineFrequencyAndEventsThai(schedule, frequencyPart, eventParts, options);
   const dayPart = describeDayOfWeekThai(schedule);
   const countPart = schedule.count !== void 0 && !standaloneOccurrenceCount ? `\u0E08\u0E33\u0E19\u0E27\u0E19 ${stripTrailingZero2(schedule.count)} \u0E04\u0E23\u0E31\u0E49\u0E07` : void 0;
   const durationPart = describeDurationThai(schedule);
@@ -12726,6 +13036,12 @@ function sameOptionalScalar(left, right) {
 function mergeOptionalScalar(left, right) {
   return left !== void 0 ? left : right;
 }
+function mergeI18nRecords2(left, right) {
+  if (!left && !right) {
+    return void 0;
+  }
+  return __spreadValues(__spreadValues({}, left != null ? left : {}), right != null ? right : {});
+}
 function sameCoding(left, right) {
   var _a2, _b;
   if (!(left == null ? void 0 : left.code) || !(right == null ? void 0 : right.code)) {
@@ -12788,6 +13104,7 @@ function mergeSite(left, right, context) {
   }
   return {
     text: mergeOptionalScalar(left.text, right.text),
+    i18n: mergeI18nRecords2(left.i18n, right.i18n),
     source: mergeOptionalScalar(left.source, right.source),
     coding: mergeOptionalScalar(left.coding, right.coding),
     spatialRelation: mergeOptionalScalar(left.spatialRelation, right.spatialRelation),
@@ -13135,6 +13452,7 @@ var TOKEN_SITE_CANDIDATES = {
   le: [{ text: "left eye", route: RouteCode["Ophthalmic route"], source: "abbreviation" }],
   ou: [{ text: "both eyes", route: RouteCode["Ophthalmic route"], source: "abbreviation" }],
   be: [{ text: "both eyes", route: RouteCode["Ophthalmic route"], source: "abbreviation" }],
+  au: [{ text: "both ears", route: RouteCode["Otic route"], source: "abbreviation" }],
   vod: [
     {
       text: "right eye",
@@ -14740,6 +15058,11 @@ var unit_terminology_default = {
       unit: "pea-sized amount",
       kind: "product_specific_amount",
       aliases: [
+        "pea",
+        "pea amount",
+        "peasize",
+        "pea-size",
+        "pea size",
         "pea sized amount",
         "pea-sized",
         "pea sized",
@@ -14836,10 +15159,96 @@ var unit_terminology_default = {
   ]
 };
 
+// src/utils/units.ts
+var MASS_UNITS = {
+  kg: 1e6,
+  g: 1e3,
+  mg: 1,
+  mcg: 1e-3,
+  ug: 1e-3,
+  microg: 1e-3,
+  ng: 1e-6
+};
+var VOLUME_UNITS = {
+  l: 1e3,
+  dl: 100,
+  ml: 1,
+  ul: 1e-3,
+  microl: 1e-3,
+  cm3: 1,
+  tsp: 5,
+  tbsp: 15
+};
+function getUnitCategory(unit) {
+  if (!unit) return "other";
+  const u = unit.toLowerCase();
+  if (MASS_UNITS[u] !== void 0) return "mass";
+  if (VOLUME_UNITS[u] !== void 0) return "volume";
+  return "other";
+}
+function getBaseUnitFactor(unit) {
+  var _a2, _b;
+  if (!unit) return 1;
+  const u = unit.toLowerCase();
+  return (_b = (_a2 = MASS_UNITS[u]) != null ? _a2 : VOLUME_UNITS[u]) != null ? _b : 1;
+}
+function convertValue(value, fromUnit, toUnit, strength) {
+  const f = fromUnit.toLowerCase();
+  const t = toUnit.toLowerCase();
+  if (f === t) return value;
+  const fCat = getUnitCategory(f);
+  const tCat = getUnitCategory(t);
+  if (fCat === tCat && fCat !== "other") {
+    const fFactor = getBaseUnitFactor(f);
+    const tFactor = getBaseUnitFactor(t);
+    return value * fFactor / tFactor;
+  }
+  if (strength && (fCat === "mass" && tCat === "volume" || fCat === "volume" && tCat === "mass")) {
+    const numUnit = strength.numerator.unit.toLowerCase();
+    const denUnit = strength.denominator.unit.toLowerCase();
+    const numCat = getUnitCategory(numUnit);
+    const denCat = getUnitCategory(denUnit);
+    if (numCat !== denCat && numCat !== "other" && denCat !== "other") {
+      const massSide = numCat === "mass" ? strength.numerator : strength.denominator;
+      const volSide = numCat === "volume" ? strength.numerator : strength.denominator;
+      const bridgeDensity = massSide.value * getBaseUnitFactor(massSide.unit) / (volSide.value * getBaseUnitFactor(volSide.unit));
+      if (fCat === "mass") {
+        const valueMg = value * getBaseUnitFactor(fromUnit);
+        const valueMl = valueMg / bridgeDensity;
+        return valueMl / getBaseUnitFactor(toUnit);
+      } else {
+        const valueMl = value * getBaseUnitFactor(fromUnit);
+        const valueMg = valueMl * bridgeDensity;
+        return valueMg / getBaseUnitFactor(toUnit);
+      }
+    }
+  }
+  return null;
+}
+
 // src/unit-lexicon.ts
 var HOUSEHOLD_VOLUME_UNIT_SET = new Set(
   HOUSEHOLD_VOLUME_UNITS.map((unit) => unit.toLowerCase())
 );
+var MASS_DISPENSED_SEMISOLID_DOSAGE_FORMS = /* @__PURE__ */ new Set([
+  "cream",
+  "ointment",
+  "gel",
+  "paste",
+  "cutaneous paste",
+  "vaginal cream",
+  "vaginal gel",
+  "oral gel",
+  "oral paste",
+  "oromucosal gel",
+  "oromucosal paste",
+  "dental gel",
+  "dental paste",
+  "gingival gel",
+  "nasal gel",
+  "eye gel",
+  "eye ointment"
+]);
 var DOSE_UNIT_TERMINOLOGY = unit_terminology_default.terms;
 var DOSE_UNIT_TERMINOLOGY_BY_KEY = /* @__PURE__ */ new Map();
 var DISCRETE_UNIT_KINDS = /* @__PURE__ */ new Set([
@@ -14902,6 +15311,47 @@ function unitApproximationOverride(unit, context) {
   }
   return void 0;
 }
+function normalizeDosageFormKey(form) {
+  var _a2;
+  const normalized = form == null ? void 0 : form.trim().toLowerCase();
+  if (!normalized) {
+    return void 0;
+  }
+  return (_a2 = KNOWN_DOSAGE_FORMS_TO_DOSE[normalized]) != null ? _a2 : normalized;
+}
+function getPreferredMassApproximationUnit(context) {
+  var _a2;
+  const normalizedDosageForm = normalizeDosageFormKey(context == null ? void 0 : context.dosageForm);
+  if (!normalizedDosageForm || !MASS_DISPENSED_SEMISOLID_DOSAGE_FORMS.has(normalizedDosageForm)) {
+    return void 0;
+  }
+  const containerUnit = (_a2 = context == null ? void 0 : context.containerUnit) == null ? void 0 : _a2.trim();
+  if (containerUnit && getUnitCategory(containerUnit) === "mass") {
+    return containerUnit;
+  }
+  const defaultUnit = normalizedDosageForm ? DEFAULT_UNIT_BY_NORMALIZED_FORM[normalizedDosageForm] : void 0;
+  return defaultUnit && getUnitCategory(defaultUnit) === "mass" ? defaultUnit : void 0;
+}
+function bridgeApproximationToMassDispensedTopical(approximation, context) {
+  const preferredMassUnit = getPreferredMassApproximationUnit(context);
+  if (!preferredMassUnit || getUnitCategory(approximation.unit) !== "volume") {
+    return approximation;
+  }
+  const sourceVolumeFactor = VOLUME_UNITS[approximation.unit.toLowerCase()];
+  const targetMassFactor = MASS_UNITS[preferredMassUnit.toLowerCase()];
+  if (!sourceVolumeFactor || !targetMassFactor) {
+    return approximation;
+  }
+  const valueMl = approximation.value * sourceVolumeFactor;
+  const valueG = valueMl;
+  const convertedValue = valueG * MASS_UNITS.g / targetMassFactor;
+  const bridgeBasis = "Mass-dispensed semisolid topical default bridge assumes 1 mL approximately equals 1 g unless a product-specific override is provided";
+  return __spreadProps(__spreadValues({}, approximation), {
+    value: convertedValue,
+    unit: preferredMassUnit,
+    basis: approximation.basis ? `${approximation.basis}; ${bridgeBasis}` : bridgeBasis
+  });
+}
 function getDoseUnitTerminologyEntry(unit) {
   var _a2;
   if (!unit) {
@@ -14923,7 +15373,11 @@ function getDoseUnitApproximation(unit, context) {
   if (override) {
     return override;
   }
-  return terminologyEntry == null ? void 0 : terminologyEntry.approximateQuantity;
+  const approximation = terminologyEntry == null ? void 0 : terminologyEntry.approximateQuantity;
+  if (!approximation) {
+    return void 0;
+  }
+  return bridgeApproximationToMassDispensedTopical(approximation, context);
 }
 function getDoseUnitSemantics(unit, context) {
   if (!unit) {
@@ -15684,6 +16138,9 @@ function inferRouteFromContext(ctx) {
 // src/hpsg/rules/site-rules.ts
 function siteBoundary(lower, context) {
   var _a2, _b, _c;
+  if (SITE_MULTIPLICITY_WORDS.has(lower)) {
+    return false;
+  }
   const siteLike = Boolean(resolveBodySitePhrase(lower, (_a2 = context.options) == null ? void 0 : _a2.siteCodeMap, {
     bodySiteContext: (_c = (_b = context.options) == null ? void 0 : _b.context) == null ? void 0 : _c.bodySiteContext
   }));
@@ -15745,7 +16202,7 @@ function shouldSuppressEyeSiteAbbreviation(context, start, lower) {
 }
 function siteLexicalRule() {
   return lexicalRule("hpsg.lex.site", (context, start) => {
-    var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o, _p, _q;
+    var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o, _p, _q, _r;
     const token = (_a2 = tokensAvailable(context, start, 1)) == null ? void 0 : _a2[0];
     if (!token) {
       return [];
@@ -15811,7 +16268,7 @@ function siteLexicalRule() {
         continue;
       }
       phraseTokens.push(candidate);
-      if (!SITE_DISPLAY_FILLERS.has(candidateLower)) {
+      if (!SITE_DISPLAY_FILLERS.has(candidateLower) || SITE_MULTIPLICITY_WORDS.has(candidateLower)) {
         displayTokens.push(candidate);
       }
     }
@@ -15857,6 +16314,7 @@ function siteLexicalRule() {
           valence: {
             site: {
               text: displayText,
+              i18n: (_r = resolved == null ? void 0 : resolved.definition) == null ? void 0 : _r.i18n,
               source: "text",
               coding: resolved == null ? void 0 : resolved.coding,
               spatialRelation: resolved == null ? void 0 : resolved.spatialRelation,
@@ -15884,7 +16342,7 @@ function siteLexicalRule() {
 }
 function bareSiteLexicalRule() {
   return lexicalRule("hpsg.lex.site.bare", (context, start) => {
-    var _a2, _b, _c, _d, _e, _f, _g, _h;
+    var _a2, _b, _c, _d, _e, _f, _g, _h, _i;
     const signs = [];
     const first = (_a2 = tokensAvailable(context, start, 1)) == null ? void 0 : _a2[0];
     if (!first) {
@@ -15930,6 +16388,7 @@ function bareSiteLexicalRule() {
             valence: {
               site: {
                 text: displayText,
+                i18n: (_h = resolved.definition) == null ? void 0 : _h.i18n,
                 source: "text",
                 coding: resolved.coding,
                 spatialRelation: resolved.spatialRelation,
@@ -15937,7 +16396,7 @@ function bareSiteLexicalRule() {
                   originalText,
                   text: sourceText,
                   normalized: sourceText.toLowerCase(),
-                  canonical: (_h = resolved.resolutionCanonical) != null ? _h : normalizeBodySiteKey(displayText),
+                  canonical: (_i = resolved.resolutionCanonical) != null ? _i : normalizeBodySiteKey(displayText),
                   isProbe,
                   inputText: context.state.input,
                   sourceText,
@@ -16165,6 +16624,64 @@ function productLexicalRule() {
 }
 function matchCompoundDoseUnit(context, start, lower) {
   var _a2;
+  const MAX_SITE_CONTEXT_TOKENS = 3;
+  const hasSiteMeaning = (lowerValue) => {
+    var _a3, _b, _c;
+    return Boolean(
+      lowerValue && (DEFAULT_BODY_SITE_SNOMED[normalizeBodySiteKey(lowerValue)] || resolveBodySitePhrase(lowerValue, (_a3 = context.options) == null ? void 0 : _a3.siteCodeMap, {
+        bodySiteContext: (_c = (_b = context.options) == null ? void 0 : _b.context) == null ? void 0 : _c.bodySiteContext
+      }))
+    );
+  };
+  const collectForwardSitePhrases = (phraseStart) => {
+    const parts = [];
+    const phrases = [];
+    for (let index = phraseStart; index < context.limit && parts.length < MAX_SITE_CONTEXT_TOKENS; index += 1) {
+      const token = context.tokens[index];
+      if (!token || context.state.consumed.has(token.index)) {
+        break;
+      }
+      const lowerValue = normalizeTokenLower(token);
+      if (!lowerValue || isPunctuation(lowerValue)) {
+        break;
+      }
+      parts.push(lowerValue);
+      phrases.push(parts.join(" "));
+    }
+    return phrases;
+  };
+  const matchesSiteContext = () => {
+    const next = context.tokens[start + 1];
+    const nextLower = next && !context.state.consumed.has(next.index) ? normalizeTokenLower(next) : void 0;
+    if (nextLower && (ROUTE_SITE_PREPOSITIONS.has(nextLower) || SITE_ANCHORS.has(nextLower))) {
+      const followingSitePhrases = collectForwardSitePhrases(start + 2);
+      if (followingSitePhrases.some((phrase) => hasSiteMeaning(phrase))) {
+        return true;
+      }
+    }
+    const previous = context.tokens[start - 1];
+    const previousLower = previous && !context.state.consumed.has(previous.index) ? normalizeTokenLower(previous) : void 0;
+    const trailingNumberBeforeUnit = Boolean(
+      previousLower && /^[0-9]+(?:\.[0-9]+)?$/.test(previousLower)
+    );
+    const siteEnd = start - (trailingNumberBeforeUnit ? 2 : 1);
+    for (let phraseLength = 1; phraseLength <= MAX_SITE_CONTEXT_TOKENS; phraseLength += 1) {
+      const phraseStart = siteEnd - phraseLength + 1;
+      if (phraseStart < 0) {
+        break;
+      }
+      const precedingAnchor = context.tokens[phraseStart - 1];
+      const precedingAnchorLower = precedingAnchor && !context.state.consumed.has(precedingAnchor.index) ? normalizeTokenLower(precedingAnchor) : void 0;
+      if (!precedingAnchorLower || !ROUTE_SITE_PREPOSITIONS.has(precedingAnchorLower) && !SITE_ANCHORS.has(precedingAnchorLower)) {
+        continue;
+      }
+      const phrase = collectForwardSitePhrases(phraseStart)[phraseLength - 1];
+      if (hasSiteMeaning(phrase)) {
+        return true;
+      }
+    }
+    return false;
+  };
   for (const compound of COMPOUND_DOSE_UNITS) {
     if (compound.head !== lower) {
       continue;
@@ -16194,6 +16711,10 @@ function matchCompoundDoseUnit(context, start, lower) {
         return head ? { unit: compound.unit, tokens: [head, next] } : void 0;
       }
     }
+    if (compound.requiresSiteContext && matchesSiteContext()) {
+      const head = context.tokens[start];
+      return head ? { unit: compound.unit, tokens: [head] } : void 0;
+    }
   }
   return void 0;
 }
@@ -17964,6 +18485,9 @@ function applySiteDefinition(internal, definition) {
   } else if ((_b = internal.siteLookupRequest) == null ? void 0 : _b.text) {
     internal.siteText = internal.siteLookupRequest.text;
   }
+  if (definition.administrationTargetCount !== void 0) {
+    internal.siteAdministrationTargetCount = definition.administrationTargetCount;
+  }
   if (definition.spatialRelation) {
     internal.siteSpatialRelation = definition.spatialRelation;
   } else if ((_c = internal.siteLookupRequest) == null ? void 0 : _c.spatialRelation) {
@@ -18316,6 +18840,9 @@ function seedKnownSiteCoding(state) {
     display: definition.coding.display,
     i18n: mergeI18nRecords(definition.i18n, definition.coding.i18n)
   };
+  if (state.siteAdministrationTargetCount === void 0) {
+    state.siteAdministrationTargetCount = definition.administrationTargetCount;
+  }
 }
 function parseClauseState(input, options) {
   const tokens = tokenize(input);
@@ -19385,73 +19912,6 @@ function suggestSig(input, options) {
   );
 }
 
-// src/utils/units.ts
-var MASS_UNITS = {
-  kg: 1e6,
-  g: 1e3,
-  mg: 1,
-  mcg: 1e-3,
-  ug: 1e-3,
-  microg: 1e-3,
-  ng: 1e-6
-};
-var VOLUME_UNITS = {
-  l: 1e3,
-  dl: 100,
-  ml: 1,
-  ul: 1e-3,
-  microl: 1e-3,
-  cm3: 1,
-  tsp: 5,
-  tbsp: 15
-};
-function getUnitCategory(unit) {
-  if (!unit) return "other";
-  const u = unit.toLowerCase();
-  if (MASS_UNITS[u] !== void 0) return "mass";
-  if (VOLUME_UNITS[u] !== void 0) return "volume";
-  return "other";
-}
-function getBaseUnitFactor(unit) {
-  var _a2, _b;
-  if (!unit) return 1;
-  const u = unit.toLowerCase();
-  return (_b = (_a2 = MASS_UNITS[u]) != null ? _a2 : VOLUME_UNITS[u]) != null ? _b : 1;
-}
-function convertValue(value, fromUnit, toUnit, strength) {
-  const f = fromUnit.toLowerCase();
-  const t = toUnit.toLowerCase();
-  if (f === t) return value;
-  const fCat = getUnitCategory(f);
-  const tCat = getUnitCategory(t);
-  if (fCat === tCat && fCat !== "other") {
-    const fFactor = getBaseUnitFactor(f);
-    const tFactor = getBaseUnitFactor(t);
-    return value * fFactor / tFactor;
-  }
-  if (strength && (fCat === "mass" && tCat === "volume" || fCat === "volume" && tCat === "mass")) {
-    const numUnit = strength.numerator.unit.toLowerCase();
-    const denUnit = strength.denominator.unit.toLowerCase();
-    const numCat = getUnitCategory(numUnit);
-    const denCat = getUnitCategory(denUnit);
-    if (numCat !== denCat && numCat !== "other" && denCat !== "other") {
-      const massSide = numCat === "mass" ? strength.numerator : strength.denominator;
-      const volSide = numCat === "volume" ? strength.numerator : strength.denominator;
-      const bridgeDensity = massSide.value * getBaseUnitFactor(massSide.unit) / (volSide.value * getBaseUnitFactor(volSide.unit));
-      if (fCat === "mass") {
-        const valueMg = value * getBaseUnitFactor(fromUnit);
-        const valueMl = valueMg / bridgeDensity;
-        return valueMl / getBaseUnitFactor(toUnit);
-      } else {
-        const valueMl = value * getBaseUnitFactor(fromUnit);
-        const valueMg = valueMl * bridgeDensity;
-        return valueMg / getBaseUnitFactor(toUnit);
-      }
-    }
-  }
-  return null;
-}
-
 // src/utils/strength.ts
 function parseStrength(strength, context) {
   var _a2, _b, _c;
@@ -19646,6 +20106,21 @@ function normalizeClock(clock) {
   }
   return `${pad(hour)}:${pad(minute)}:${pad(second)}`;
 }
+function doseUnitSupportsPerTargetMultiplication(doseUnit, context) {
+  const semantics = getDoseUnitSemantics(doseUnit, context);
+  if (!semantics) {
+    return false;
+  }
+  return semantics.kind !== "metric" && semantics.kind !== "biologic_unit";
+}
+function getAdministrationTargetMultiplier(dosage, context) {
+  var _a2, _b, _c, _d;
+  const doseUnit = (_c = (_b = (_a2 = dosage.doseAndRate) == null ? void 0 : _a2[0]) == null ? void 0 : _b.doseQuantity) == null ? void 0 : _c.unit;
+  if (!doseUnitSupportsPerTargetMultiplication(doseUnit, context)) {
+    return 1;
+  }
+  return (_d = getBodySiteAdministrationTargetCount(dosage.site)) != null ? _d : 1;
+}
 function getDateTimeFormat(timeZone) {
   let formatter = dateTimeFormatCache.get(timeZone);
   if (!formatter) {
@@ -19876,6 +20351,24 @@ function estimateIngredientQuantity(quantity, context) {
   if (!(numerator == null ? void 0 : numerator.unit) || numerator.value === void 0 || !(denominator == null ? void 0 : denominator.unit) || denominator.value === void 0) {
     return void 0;
   }
+  const quantityCategory = getUnitCategory(quantity.unit);
+  const denominatorCategory = getUnitCategory(denominator.unit);
+  if (quantityCategory !== "other" && quantityCategory === denominatorCategory) {
+    const quantityInDenominatorBase = quantity.value * getBaseUnitFactor(quantity.unit);
+    const denominatorInBase = denominator.value * getBaseUnitFactor(denominator.unit);
+    const numeratorInBase = numerator.value * getBaseUnitFactor(numerator.unit);
+    if (denominatorInBase !== 0) {
+      return {
+        value: roundCalculatedUnits(
+          quantityInDenominatorBase * numeratorInBase / denominatorInBase / getBaseUnitFactor(numerator.unit)
+        ),
+        unit: numerator.unit,
+        confidence: quantity.confidence,
+        basis: quantity.basis,
+        source: quantity.source
+      };
+    }
+  }
   const converted = convertValue(
     quantity.value,
     quantity.unit,
@@ -21065,7 +21558,8 @@ function calculateTotalUnitsSingle(options) {
     2e3
   );
   const doseQuantity = (_j = (_i = (_h = (_g = dosage.doseAndRate) == null ? void 0 : _g[0]) == null ? void 0 : _h.doseQuantity) == null ? void 0 : _i.value) != null ? _j : 0;
-  let totalUnits = roundCalculatedUnits(count * doseQuantity);
+  const targetMultiplier = getAdministrationTargetMultiplier(dosage, context);
+  let totalUnits = roundCalculatedUnits(count * doseQuantity * targetMultiplier);
   if (roundToMultiple && roundToMultiple > 0) {
     totalUnits = roundCalculatedUnits(Math.ceil(totalUnits / roundToMultiple) * roundToMultiple);
   }
@@ -21621,7 +22115,7 @@ function cloneBodySiteCoding2(coding) {
   };
 }
 function buildNormalizedMetaFromClause(clause, fhir, options) {
-  var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o, _p, _q, _r, _s, _t, _u, _v, _w, _x, _y, _z, _A, _B, _C, _D, _E, _F;
+  var _a2, _b, _c, _d, _e, _f, _g, _h, _i, _j, _k, _l, _m, _n, _o, _p, _q, _r, _s, _t, _u, _v, _w, _x, _y, _z, _A, _B, _C, _D, _E, _F, _G, _H;
   const additionalInstructions = ((_a2 = clause.additionalInstructions) == null ? void 0 : _a2.length) ? clause.additionalInstructions.map((instruction) => ({
     text: instruction.text,
     coding: cloneCoding2(instruction.coding)
@@ -21634,22 +22128,23 @@ function buildNormalizedMetaFromClause(clause, fhir, options) {
     unit: (_h = clause.dose) == null ? void 0 : _h.unit,
     unitKind: unitSemantics == null ? void 0 : unitSemantics.kind,
     unitSemantics,
-    site: ((_i = clause.site) == null ? void 0 : _i.text) || ((_k = (_j = clause.site) == null ? void 0 : _j.coding) == null ? void 0 : _k.code) || ((_l = clause.site) == null ? void 0 : _l.spatialRelation) ? {
-      text: (_m = clause.site) == null ? void 0 : _m.text,
+    site: ((_i = clause.site) == null ? void 0 : _i.text) || ((_k = (_j = clause.site) == null ? void 0 : _j.coding) == null ? void 0 : _k.code) || ((_l = clause.site) == null ? void 0 : _l.spatialRelation) || ((_m = clause.site) == null ? void 0 : _m.administrationTargetCount) !== void 0 ? {
+      text: (_n = clause.site) == null ? void 0 : _n.text,
       coding: siteCoding,
-      spatialRelation: cloneBodySiteSpatialRelation((_n = clause.site) == null ? void 0 : _n.spatialRelation)
+      spatialRelation: cloneBodySiteSpatialRelation((_o = clause.site) == null ? void 0 : _o.spatialRelation),
+      administrationTargetCount: (_p = clause.site) == null ? void 0 : _p.administrationTargetCount
     } : void 0,
-    method: ((_o = clause.method) == null ? void 0 : _o.text) || ((_q = (_p = clause.method) == null ? void 0 : _p.coding) == null ? void 0 : _q.code) ? {
-      text: (_r = clause.method) == null ? void 0 : _r.text,
-      coding: cloneCoding2((_s = clause.method) == null ? void 0 : _s.coding)
+    method: ((_q = clause.method) == null ? void 0 : _q.text) || ((_s = (_r = clause.method) == null ? void 0 : _r.coding) == null ? void 0 : _s.code) ? {
+      text: (_t = clause.method) == null ? void 0 : _t.text,
+      coding: cloneCoding2((_u = clause.method) == null ? void 0 : _u.coding)
     } : void 0,
     patientInstruction: clause.patientInstruction,
-    prnReason: ((_u = (_t = clause.prn) == null ? void 0 : _t.reason) == null ? void 0 : _u.text) || ((_x = (_w = (_v = clause.prn) == null ? void 0 : _v.reason) == null ? void 0 : _w.coding) == null ? void 0 : _x.code) ? {
-      text: (_z = (_y = clause.prn) == null ? void 0 : _y.reason) == null ? void 0 : _z.text,
-      coding: cloneCoding2((_B = (_A = clause.prn) == null ? void 0 : _A.reason) == null ? void 0 : _B.coding),
-      spatialRelation: cloneBodySiteSpatialRelation((_D = (_C = clause.prn) == null ? void 0 : _C.reason) == null ? void 0 : _D.spatialRelation)
+    prnReason: ((_w = (_v = clause.prn) == null ? void 0 : _v.reason) == null ? void 0 : _w.text) || ((_z = (_y = (_x = clause.prn) == null ? void 0 : _x.reason) == null ? void 0 : _y.coding) == null ? void 0 : _z.code) ? {
+      text: (_B = (_A = clause.prn) == null ? void 0 : _A.reason) == null ? void 0 : _B.text,
+      coding: cloneCoding2((_D = (_C = clause.prn) == null ? void 0 : _C.reason) == null ? void 0 : _D.coding),
+      spatialRelation: cloneBodySiteSpatialRelation((_F = (_E = clause.prn) == null ? void 0 : _E.reason) == null ? void 0 : _F.spatialRelation)
     } : void 0,
-    prnReasons: ((_F = (_E = clause.prn) == null ? void 0 : _E.reasons) == null ? void 0 : _F.length) ? clause.prn.reasons.map((reason) => ({
+    prnReasons: ((_H = (_G = clause.prn) == null ? void 0 : _G.reasons) == null ? void 0 : _H.length) ? clause.prn.reasons.map((reason) => ({
       text: reason.text,
       coding: cloneCoding2(reason.coding),
       spatialRelation: cloneBodySiteSpatialRelation(reason.spatialRelation)
@@ -21847,6 +22342,7 @@ export {
   AdviceModality,
   AdvicePolarity,
   AdviceRelation,
+  BODY_SITE_ADMINISTRATION_TARGET_COUNT_EXTENSION_URL,
   BODY_SITE_SPATIAL_RELATION_EXTENSION_URL,
   DEFAULT_BODY_SITE_SNOMED,
   DEFAULT_BODY_SITE_SNOMED_SOURCE,
@@ -21871,6 +22367,7 @@ export {
   SNOMED_CT_TOPOGRAPHICAL_MODIFIER_CODE,
   SNOMED_CT_TOPOGRAPHICAL_MODIFIER_DISPLAY,
   SNOMED_SYSTEM,
+  buildBodySiteAdministrationTargetCountExtension,
   buildBodySiteSpatialRelationExtension,
   buildBodySiteSpatialRelationExtensions,
   buildBodySiteTopographicalModifierCoding,
@@ -21884,6 +22381,7 @@ export {
   formatSig,
   formatSigBatch,
   fromFhirDosage,
+  getBodySiteAdministrationTargetCount,
   getBodySiteCode,
   getBodySiteCodeAsync,
   getBodySiteText,
@@ -21902,6 +22400,7 @@ export {
   lookupBodySite,
   lookupBodySiteAsync,
   nextDueDoses,
+  parseBodySiteAdministrationTargetCountExtension,
   parseBodySiteSpatialRelationExtension,
   parseSig,
   parseSigAsync,