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data.xml.sample
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<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="CDA.xsl"?>
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:schemaLocation="urn:hl7-org:v3 ../../../../../CDA%20Academy/ccda-schemas/ccda-schemas/infrastructure/cda/CDA_SDTC.xsd"
xmlns="urn:hl7-org:v3" xmlns:cda="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc">
<!--
********************************************************
CDA Header
********************************************************
-->
<!-- CONF 16791 -->
<realmCode code="US"/>
<!-- CONF 5361 -->
<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
<!-- US General Header Template -->
<!-- CONF 5252 -->
<templateId root="2.16.840.1.113883.10.20.22.1.1"/>
<!-- *** Note: The next templateId, code and title will differ depending on what type of document is being sent. *** -->
<!-- conforms to the document specific requirements -->
<templateId root="2.16.840.1.113883.10.20.22.1.2"/>
<!-- CONF 5363 -->
<id extension="Test CCDA" root="1.1.1.1.1.1.1.1.1"/>
<!-- CONF 5253 "CCD document" -->
<code codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" code="34133-9"
displayName="Summarization of Episode Note"/>
<!-- CONF 5254 -->
<title>Primo Adult Health: Health Summary</title>
<!-- CONF 5256 -->
<effectiveTime value="20121126000000-0000"/>
<!-- 5259 -->
<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
<!-- 5372 -->
<languageCode code="en-US"/>
<!-- CONF 5266 -->
<recordTarget>
<!-- CONF 5267 -->
<patientRole>
<!-- CONF 5268-->
<!-- Patient SSN recorded as an ID -->
<id extension="123-456-7890" root="2.16.840.1.113883.4.1"/>
<!-- CONF 5271 -->
<addr use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>100 Marshall Lane</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22153</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</addr>
<!-- CONF 5280 -->
<telecom value="tel:+1(571)555-0189" use="HP"/>
<!-- HP is "primary home" from HL7 AddressUse 2.16.840.1.113883.5.1119 -->
<!-- CONF 5283 -->
<patient>
<!-- CONF 5284 -->
<name use="L">
<!-- L is "Legal" from HL7 EntityNameUse 2.16.840.1.113883.5.45 -->
<given>Nikolai</given>
<family>Bellic</family>
</name>
<administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"
displayName="Male" codeSystemName="AdministrativeGender"/>
<birthTime value="19330316"/>
<maritalStatusCode code="M" displayName="Married" codeSystem="2.16.840.1.113883.5.2"
codeSystemName="MaritalStatus"/>
<religiousAffiliationCode code="1041" displayName="Roman Catholic" codeSystem="2.16.840.1.113883.5.1076" codeSystemName="ReligiousAffiliation"/>
<raceCode code="2106-3" displayName="White"
codeSystem="2.16.840.1.113883.6.238"
codeSystemName="OMB Standards for Race and Ethnicity"/>
<ethnicGroupCode code="2186-5" displayName="Not Hispanic or Latino"
codeSystem="2.16.840.1.113883.6.238"
codeSystemName="OMB Standards for Race and Ethnicity"/>
<languageCommunication>
<!-- CONF 5407: LanguageCode Code System 2.16.840.1.113883.1.11.11526 -->
<languageCode code="en"/>
<modeCode code="ESP" displayName="Expressed spoken"
codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode"/>
</languageCommunication>
</patient>
</patientRole>
</recordTarget>
<author>
<time value="20121126000000"/>
<assignedAuthor>
<!-- NPI 12345 -->
<id extension="12345" root="2.16.840.1.113883.4.6"/>
<code code="207QA0505X" codeSystem="2.16.840.1.113883.6.101"
displayName="Adult Medicine" codeSystemName="NUCC"/>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(571)555-0179;ext=221"/>
<assignedPerson>
<name>
<given>Raymond</given>
<family>Boccino</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<dataEnterer>
<assignedEntity>
<id extension="678910" root="1.1.1.1.1.1.1.1.2"/>
<code code="364SA2200X" displayName="Adult Health"
codeSystem="2.16.840.1.113883.6.101" codeSystemName="NUCC"/>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(571)555-0179;ext=222"/>
<assignedPerson>
<name>
<given>Mallory</given>
<family>Bardas</family>
<suffix>RN</suffix>
</name>
</assignedPerson>
</assignedEntity>
</dataEnterer>
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id root="1.1.1.1.1.1.1.1.2"/>
<name>Primo Adult Health</name>
<telecom use="WP" value="tel:+1(571)555-0179"/>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<informationRecipient>
<intendedRecipient>
<!-- NPI 23456 -->
<id extension="23456" root="2.16.840.1.113883.4.6"/>
<informationRecipient>
<name>
<given>Bernard</given>
<family>Crane</family>
<suffix>MD</suffix>
</name>
</informationRecipient>
<receivedOrganization>
<name>Springfield Geriatric Associates</name>
<telecom use="WP" value="tel:+1(571)555-0165"/>
<addr>
<streetAddressLine>202 County Line Rd</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
<standardIndustryClassCode code="207QG0300X" displayName="Geriatric Medicine"
codeSystem="2.16.840.1.113883.6.101" codeSystemName="NUCC"/>
</receivedOrganization>
</intendedRecipient>
</informationRecipient>
<legalAuthenticator>
<time value="20121126000000"/>
<signatureCode code="S"/>
<assignedEntity>
<!-- NPI 12345 -->
<id extension="12345" root="2.16.840.1.113883.4.6"/>
<code code="207QA0505X" codeSystem="2.16.840.1.113883.6.101"
displayName="Adult Medicine" codeSystemName="NUCC"/>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(571)555-0179;ext=221"/>
<assignedPerson>
<name>
<given>Raymond</given>
<family>Boccino</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedEntity>
</legalAuthenticator>
<participant typeCode="IND">
<associatedEntity classCode="PRS">
<addr>
<streetAddressLine>100 Marshall Lane</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22153</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(571)555-0189"/>
<associatedPerson>
<name>
<given>Kathleen</given>
<family>McReary</family>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<documentationOf>
<serviceEvent classCode="PCPR">
<effectiveTime>
<low value="19330316"/>
<high value="20121126"/>
</effectiveTime>
<performer typeCode="PRF">
<assignedEntity>
<!-- NPI 34567 -->
<id extension="34567" root="2.16.840.1.113883.4.6"/>
<code code="207RC0000X" codeSystem="2.16.840.1.113883.6.101" codeSystemName="NUCC"
displayName="Cardiovascular Disease"/>
<addr>
<streetAddressLine>209 County Line Rd</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
</addr>
<telecom use="WP" value="tel:+1(571)555-0155"/>
<assignedPerson>
<name>
<given>Dwayne</given>
<family>Forge</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<performer typeCode="PRF">
<functionCode code="PCP" displayName="Primary Care Physician" codeSystem="2.16.840.1.113883.5.88" codeSystemName="participationFunction"/>
<assignedEntity>
<!-- NPI 12345 -->
<id extension="12345" root="2.16.840.1.113883.4.6"/>
<code code="207QA0505X" codeSystem="2.16.840.1.113883.6.101"
displayName="Adult Medicine" codeSystemName="NUCC"/>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(571)555-0179;ext=221"/>
<assignedPerson>
<name>
<given>Raymond</given>
<family>Boccino</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>
<componentOf>
<encompassingEncounter>
<id root="8d2f5ec8-7356-4740-b6d7-6c29419ad956"/>
<effectiveTime>
<low value="201211261400"/>
<high value="201211261436"/>
</effectiveTime>
<responsibleParty>
<assignedEntity>
<!-- NPI 12345 -->
<id extension="12345" root="2.16.840.1.113883.4.6"/>
<code code="207QA0505X" codeSystem="2.16.840.1.113883.6.101"
displayName="Adult Medicine" codeSystemName="NUCC"/>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(571)555-0179;ext=221"/>
<assignedPerson>
<name>
<given>Raymond</given>
<family>Boccino</family>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedEntity>
</responsibleParty>
<location>
<healthCareFacility>
<id root="1.1.1.1.1.1.1.1.2"/>
<code code="261QP2300X" displayName="Primary Care" codeSystem="2.16.840.1.113883.6.101" codeSystemName="NUCC"/>
<location>
<name>Primo Adult Health</name>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
</location>
<serviceProviderOrganization>
<id root="1.1.1.1.1.1.1.1.2"/>
<name>Primo Adult Health</name>
<telecom use="WP" value="tel:+1(571)555-0179"/>
<addr>
<streetAddressLine>1400 Main Street Ste G</streetAddressLine>
<city>Springfield</city>
<state>VA</state>
<postalCode>22150</postalCode>
<country>US</country>
</addr>
<standardIndustryClassCode code="261QP2300X" displayName="Primary Care" codeSystem="2.16.840.1.113883.6.101" codeSystemName="NUCC"/>
</serviceProviderOrganization>
</healthCareFacility>
</location>
</encompassingEncounter>
</componentOf>
<!-- ********************************************************
CDA Body
******************************************************** -->
<component>
<structuredBody>
<!-- *********************** -->
<!--
********************************************************
Advanced Directives (entries optional)
********************************************************
-->
<component>
<section>
<!-- Advance Directives Section (entries optional) -->
<templateId root="2.16.840.1.113883.10.20.22.2.21"/>
<code code="42348-3" displayName="Advance Directives" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<title>ADVANCE DIRECTIVES</title>
<text>
<paragraph>No advance directives exist for this patient.</paragraph>
</text>
</section>
</component>
<!--
********************************************************
Allergies (entries required)
********************************************************
-->
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
<!-- Allergies (entries required) section template -->
<code code="48765-2" codeSystem="2.16.840.1.113883.6.1"/>
<title>ALLERGIES</title>
<text>
<list listType="ordered">
<item><content ID="allergy1">Allergy to Penicillin drugs</content></item>
<item><content ID="allergy2">Allergy to Bee Pollen</content></item>
</list>
</text>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="200b7b4e-dcc2-47d2-8bce-2ce612dd4647"/>
<code code="48765-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="Allergies, adverse reactions, alerts"/>
<statusCode code="active"/>
<effectiveTime>
<low value="19600101"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="4a51d40f-db9f-414a-b7cf-d3c40c00835a"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<effectiveTime>
<low nullFlavor="UNK"/>
</effectiveTime>
<value xsi:type="CD" code="416098002" displayName="drug allergy"
codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT">
<originalText>
<reference value="#allergy1"/>
</originalText>
</value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<code code="70618" displayName="Penicillin"
codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm">
<originalText>
<reference value="#allergy1"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy1"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="19600101"/>
</effectiveTime>
<value xsi:type="CD" code="404640003"
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<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" xsi:type="CE"
codeSystem="2.16.840.1.113883.5.4"
codeSystemName="ActCode"/>
<text>
<reference value="#allergy1"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="6736007"
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</entryRelationship>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<!-- ** Allergy problem act ** -->
<id root="1857d9c8-b58f-43ef-adef-7b2999c92f5e"/>
<code code="48765-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="Allergies, adverse reactions, alerts"/>
<statusCode code="active"/>
<effectiveTime>
<low value="19400101"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="6af77782-e02b-41b5-b81f-9699432a3e1b"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<effectiveTime>
<low nullFlavor="UNK"/>
</effectiveTime>
<value xsi:type="CD" code="419199007" displayName="allergy to substance"
codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT">
<originalText>
<reference value="#allergy2"/>
</originalText>
</value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<code code="3729L8MA2C" displayName="Bee Pollen"
codeSystem="2.16.840.1.113883.4.9" codeSystemName="UNII">
<originalText>
<reference value="#allergy2"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="8a07406a-78e7-4484-b0f6-f8ad522cb36e"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy2"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="19400101"/>
</effectiveTime>
<value xsi:type="CD" code="417516000"
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<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" xsi:type="CE"
codeSystem="2.16.840.1.113883.5.4"
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<text>
<reference value="#allergy2"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="24484000"
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codeSystemName="SNOMED CT" displayName="severe"
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</observation>
</entryRelationship>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
</section>
</component>
<!--
************************************
REASON FOR VISIT
************************************
-->
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.12"/>
<code code="29299-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="REASON FOR VISIT"/>
<title>REASON FOR VISIT</title>
<text>
<paragraph>Recent falls</paragraph>
</text>
</section>
</component>
<!--
************************************
FAMILY HISTORY
************************************
-->
<component>
<section>
<!-- Family history section template -->
<templateId root="2.16.840.1.113883.10.20.22.2.15"/>
<code code="10157-6" displayName="Family History" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<title>FAMILY HISTORY</title>
<text>
<paragraph>Non-contributory</paragraph>
</text>
</section>
</component>
<!--
********************************************************
FUNCTIONAL and COGNITIVE STATUS
********************************************************
-->
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.14"/>
<!-- ******** Functional status section template ******** -->
<code code="47420-5" codeSystem="2.16.840.1.113883.6.1"/>
<title>FUNCTIONAL STATUS</title>
<text> Difficulty remembering dates. Patient uses cane for walking.</text>
</section>
</component>
<!--
********************************************************
IMMUNIZATIONS
********************************************************
-->
<component>
<section>
<!-- ******** Immunizations (entries required) section template ******** -->
<templateId root="2.16.840.1.113883.10.20.22.2.2.1"/>
<code code="11369-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="History of immunizations"/>
<title>IMMUNIZATIONS</title>
<text>
<list listType="ordered">
<item><content ID="immunization1">Influenza, seasonal, injectable, preservative free</content></item>
</list>
</text>
<entry>
<substanceAdministration moodCode="EVN" classCode="SBADM" negationInd="true">
<!-- Immunization Activity entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="b82150ba-bc2f-47a2-947c-930e3b4a3a5b"/>
<statusCode code="completed"/>
<effectiveTime value="20121126"/>
<consumable>
<manufacturedProduct classCode="MANU">
<!-- Immunization Medication Information template -->
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="140" displayName="Influenza, seasonal, injectable, preservative free" codeSystem="2.16.840.1.113883.12.292" codeSystemName="Vaccines administered (CVX)">
<originalText>
<reference value="#immunization1"/>
</originalText>
</code>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Influenza Vaccine Company</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
</section>
</component>
<!--
********************************************************
INSTRUCTIONS
********************************************************
-->
<component>
<section>
<!-- Instructions template ID -->
<templateId root="2.16.840.1.113883.10.20.22.2.45"/>
<id root="184fdbe3-f480-4199-976d-e0bb0dd02551"/>
<code code="69730-0" codeSystem="2.16.840.1.113883.6.1" codeSystemVersion="LOINC"
displayName="Instructions"/>
<title>INSTRUCTIONS</title>
<text>
<paragraph>Patient is to schedule follow-up appointment with PCP after consultation.</paragraph>
</text>
</section>
</component>
<!--
********************************************************
MEDICATIONS
********************************************************
-->
<component>
<section>
<!-- Medication Section (entries required) -->
<templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
<code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
displayName="HISTORY OF MEDICATION USE"/>
<title>MEDICATIONS</title>
<text>
<list listType="ordered">
<item><content ID="medication1">Lisinopril - 20mg by mouth once daily</content></item>
<item><content ID="medication2">Lasix - 40mg by mouth once daily</content></item>
<item><content ID="medication3">K-Dur - 10mEq/L by mouth once daily</content></item>
<item><content ID="medication4">Norvasc - 10mg by mouth once daily</content></item>
<item><content ID="medication5">Zocor - 40mg by mouth once daily before bed</content></item>
<item><content ID="medication6">Lantus - 36 units once daily before bed</content></item>
<item><content ID="medication7">gliburide - 2.5mg by mouth once daily</content></item>
<item><content ID="medication8">synthroid - 0.1mg by mouth once daily</content></item>
<item><content ID="medication9">Aleve - 220mg by mouth twice daily</content></item>
<item><content ID="medication10">Ultram - 50mg by mouth four times daily as needed for joint pain</content></item>
<item><content ID="medication11">Aspirin - 81mg by mouth once daily</content></item>
<item><content ID="medication12">Lopressor - 50mg by mouth twice daily</content></item>
<item><content ID="medication13">Flomax - 0.4mg by mouth once daily</content></item>
<item><content ID="medication14">Proscar - 5mg by mouth once daily</content></item>
<item><content ID="medication15">Neurontin - 300mg by mouth three times daily</content></item>
<item><content ID="medication16">Ativan - 1mg by mouth three times daily as needed for irritability</content></item>
<item><content ID="medication17">miodarone - 200mg by mouth two times daily</content></item>
<item><content ID="medication18">Coumadin - 5mg by mouth every other day starting 11/1/2012</content></item>
<item><content ID="medication19">Coumadin - 2.5mg by mouth every other day starting 11/2/2012</content></item>
<item><content ID="medication20">Ambien - 5mg by mouth once daily before bed</content></item>
</list>
</text>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="f51687b3-19dc-445d-a3aa-8d756276c89f"/>
<text>
<reference value="#medication1"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
<period value="24" unit="h"/>
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<administrationUnitCode code="C42998" displayName="tablet"
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<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="314077" codeSystem="2.16.840.1.113883.6.88"
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<originalText>
<reference value="#medication1"/>
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</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="23581045-ee58-4a16-9a4c-d722a43d93f8"/>
<text>
<reference value="#medication2"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
<period value="24" unit="h"/>
</effectiveTime>
<routeCode code="C38288" displayName="oral"
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<doseQuantity value="1"/>
<administrationUnitCode code="C42998" displayName="tablet"
codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus"/>
<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="313988" codeSystem="2.16.840.1.113883.6.88"
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displayName="Furosemide 40 MG Oral Tablet">
<originalText>
<reference value="#medication2"/>
</originalText>
</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="becaa0c7-7916-4de3-b7cd-1b8be342087d"/>
<text>
<reference value="#medication3"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
<period value="24" unit="h"/>
</effectiveTime>
<routeCode code="C38288" displayName="oral"
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<doseQuantity value="1"/>
<administrationUnitCode code="C42927" displayName="TABLET, EXTENDED RELEASE"
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<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="706459" codeSystem="2.16.840.1.113883.6.88"
codeSystemName="RxNorm"
displayName="K-Dur 10 MEQ Extended Release Tablet">
<originalText>
<reference value="#medication3"/>
</originalText>
</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="f9fa3786-a767-4ca8-add4-72b61347aa0f"/>
<text>
<reference value="#medication4"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
<period value="24" unit="h"/>
</effectiveTime>
<routeCode code="C38288" displayName="oral"
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<doseQuantity value="1"/>
<administrationUnitCode code="C42998" displayName="tablet"
codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus"/>
<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="308135" codeSystem="2.16.840.1.113883.6.88"
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<originalText>
<reference value="#medication4"/>
</originalText>
</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="4a55ddeb-5aa6-47f0-b455-da9b5f7f9c75"/>
<text>
<reference value="#medication5"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="EIVL_TS" operator="A">
<event code="HS"/>
</effectiveTime>
<routeCode code="C38288" displayName="oral"
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<doseQuantity value="1"/>
<administrationUnitCode code="C42998" displayName="tablet"
codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus"/>
<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="198211" codeSystem="2.16.840.1.113883.6.88"
codeSystemName="RxNorm"
displayName="Simvastatin 40 MG Oral Tablet">
<originalText>
<reference value="#medication5"/>
</originalText>
</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="e146441f-d8db-451b-9b0a-b95d19da358a"/>
<text>
<reference value="#medication6"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="EIVL_TS" operator="A">
<event code="HS"/>
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<routeCode code="C38299" displayName="SUBCUTANEOUS"
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<doseQuantity value="0.36" unit="ml"/>
<administrationUnitCode code="C42945" displayName="INJECTION, SOLUTION"
codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus"/>
<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="311041" codeSystem="2.16.840.1.113883.6.88"
codeSystemName="RxNorm"
displayName="Insulin Glargine 100 UNT/ML Injectable Solution">
<originalText>
<reference value="#medication6"/>
</originalText>
</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="2f673e36-79de-45a3-ae20-321e561d41f5"/>
<text>
<reference value="#medication7"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
<period value="24" unit="h"/>
</effectiveTime>
<routeCode code="C38288" displayName="oral"
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<doseQuantity value="1"/>
<administrationUnitCode code="C42998" displayName="tablet"
codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus"/>
<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="861748" codeSystem="2.16.840.1.113883.6.88"
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displayName="glyBURIDE 2.5 MG / metFORMIN hydrochloride 500 MG Oral Tablet">
<originalText>
<reference value="#medication7"/>
</originalText>
</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="a47c03f4-7930-40cd-ad06-8ab82537c706"/>
<text>
<reference value="#medication8"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20121101"/>
<high value="20121231"/>
</effectiveTime>
<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
<period value="24" unit="h"/>
</effectiveTime>
<routeCode code="C38288" displayName="oral"
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<doseQuantity value="1"/>
<administrationUnitCode code="C42998" displayName="tablet"
codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="NCI Thesaurus"/>
<consumable>
<manufacturedProduct classCode="MANU">
<!-- Medication Information Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial>
<code code="892246" codeSystem="2.16.840.1.113883.6.88"
codeSystemName="RxNorm"
displayName="Levothyroxine Sodium 0.1 MG Oral Tablet">
<originalText>
<reference value="#medication8"/>
</originalText>
</code>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN">
<!-- Medication Activity Entry template -->
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>