In the center of the mandala Medicine Buddha is sitting on the lotus.
The mandala of medicine Buddha has three levels of external, internal and absolute. It is used to practice in order to realize these three levels.
External level means devotion to the Medicine Buddha offering the mandala and the practice of medicine.
Inner level means the tantric practice of identifying oneself with the medicine Buddha and one's world with the energies of the pure medicine land.
Absolute level means the ultimate realization of oneself like the Medicine Buddha who continuously manifests the Healing Power.
The mandala practicing through such practices is to realize the Trikaya, the Buddha nature of body, speech, and mind, action, radiance, and emptiness.