USCDI V3 CCDA: Invalid id root is appearing in CCDA file resulting in errors in HealthIT CCDA Validator
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Amit Patil
Aug 14, 2025, 12:32:17 PMAug 14
to Edge Test Tool (ETT)
Hello Community,
I’m currently working on validating the 170.315_b1_toc_amb_svap_uscdiv3_sample1_v1 CCDA document using the CCDAV3 validator, and I'm encountering an issue related to invalid root id for Payers>> Guarantor>> entryRelationship node in CCDA file.
Health IT Validation error:
CCDA File screenshot:
It seems extension value is getting inserted to id root and if we try to provide valid ID root with the extension (For ex. <id root="2.16.840.1.113883.19.5" extension="765600201"/>), CCDA Validator throws Null Pointer exception. Please see below screenshot:
Please advise on how to overcome this issue.
Best Regards,
Amit Patil
Nagesh Bashyam
Aug 14, 2025, 12:52:00 PMAug 14
to Amit Patil, Edge Test Tool (ETT)
Can you please attach the XML file ?
From:
edge-te...@googlegroups.com <edge-te...@googlegroups.com> on behalf of Amit Patil <amitpa...@gmail.com>
Date: Thursday, August 14, 2025 at 12:32 PM
To: Edge Test Tool (ETT) <edge-te...@googlegroups.com>
Subject: USCDI V3 CCDA: Invalid id root is appearing in CCDA file resulting in errors in HealthIT CCDA Validator
Hello Community,
I’m currently working on validating the 170.315_b1_toc_amb_svap_uscdiv3_sample1_v1 CCDA document using the CCDAV3 validator, and I'm encountering an issue related to invalid root id for Payers>> Guarantor>> entryRelationship node in CCDA file.
Health IT Validation error:
CCDA File screenshot:
It seems extension value is getting inserted to id root and if we try to provide valid ID root with the extension (For ex. <id root="2.16.840.1.113883.19.5" extension="765600201"/>), CCDA Validator throws Null Pointer exception. Please see below screenshot:
Please advise on how to overcome this issue.
Best Regards,
Amit Patil
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br...@waveoneassociates.com
Aug 14, 2025, 1:16:53 PMAug 14
to Edge Test Tool (ETT)
Hi, Amit,
Looks like a bad UUID in the root which is tripping up the validator!
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Amit Patil
Aug 19, 2025, 5:28:22 AMAug 19
to Edge Test Tool (ETT)
Hi Nagesh,
Attaching the CCDA file as below:
<?xml-stylesheet type="text/xsl"
href="https://viewer-sdo-us.csg.mdrxdev.com/stylesheets/ced/4.0/ced.xsl"
alternate="no" title="Allscripts Default" ?>
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<realmCode code="US"/>
<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
<templateId root="2.16.840.1.113883.10.20.22.1.2" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.1.2"/>
<templateId root="2.16.840.1.113883.3.3251.1.1"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2023-05-01"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.5.5.1"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.5.5.2"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.1" extension="54845"/>
<code code="34133-9" codeSystem="2.16.840.1.113883.6.1"/>
<title>Continuity of Care Document</title>
<effectiveTime value="20250812125623-0400"/>
<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
<languageCode code="en-US"/>
<recordTarget>
<patientRole>
<id extension="111032" root="1.3.6.1.4.1.22812.11.2021.1"/>
<addr use="H">
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
<useablePeriod xsi:type="IVL_TS">
<low value="20220317"/>
</useablePeriod>
</addr>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<telecom use="MC" value="tel:+1-(555)777-1234"/>
<telecom value="mailto:Y...@test.com"/>
<patient>
<name use="L">
<family>Newman</family>
<given>Alice</given>
<given>Jones</given>
<validTime>
<low value="20220317145542+0000"/>
</validTime>
</name>
<name>
<family>Newman</family>
<given>Al</given>
<given>Jones</given>
<validTime>
<low value="20230713204806+0000"/>
<high value="20230713204806+0000"/>
</validTime>
</name>
<name>
<family qualifier="BR">Newman</family>
<given qualifier="BR">Alicia</given>
<prefix>BR</prefix>
<validTime>
<low value="20220317145543+0000"/>
</validTime>
</name>
<administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1"/>
<birthTime value="19700501"/>
<raceCode code="2106-3" codeSystem="2.16.840.1.113883.6.238"
displayName="White"/>
<sdtc:raceCode code="2108-9" codeSystem="2.16.840.1.113883.6.238"
displayName="White"/>
<ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.6.238"
displayName="Not Hispanic or Latino"/>
<!-- <sdtc:ethnicGroupCode code="2186-5"
codeSystem="2.16.840.1.113883.6.238" displayName="Not Hispanic or Latino"/>
-->
<languageCommunication>
<languageCode code="en"/>
<preferenceInd value="true"/>
</languageCommunication>
</patient>
<providerOrganization>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1"/>
<name>Neighborhood Physicians Practi</name>
<telecom nullFlavor="NI"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</providerOrganization>
</patientRole>
</recordTarget>
<author>
<templateId root="2.16.840.1.113883.3.3251.1.2"/>
<time value="20250812125623-0400"/>
<assignedAuthor>
<templateId root="2.16.840.1.113883.3.3251.1.3"/>
<id extension="205301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<id extension="2222222541" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr use="WP">
<streetAddressLine>Tracy Davis</streetAddressLine>
<streetAddressLine>2472 Rocky Place</streetAddressLine>
<city>Beaverton</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Davis</family>
<given>Albert</given>
<suffix>Physician</suffix>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<author>
<time value="20250812125623-0400"/>
<assignedAuthor>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1.3.3"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedAuthoringDevice>
<manufacturerModelName>Sunrise Clinical Manager </manufacturerModelName>
<softwareName>Sunrise Clinical Manager </softwareName>
</assignedAuthoringDevice>
<representedOrganization>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1"/>
<name>Neighborhood Physicians Practi</name>
<telecom nullFlavor="NI"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</representedOrganization>
</assignedAuthor>
</author>
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1"/>
<name>Neighborhood Physicians Practi</name>
<telecom nullFlavor="NI"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<informationRecipient>
<intendedRecipient>
<id root="1.3.6.1.4.1.22812.11.2021.1.3.1" extension="1"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
<receivedOrganization>
<id nullFlavor="NI"/>
<name>Neighborhood Physicians Practi</name>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</receivedOrganization>
</intendedRecipient>
</informationRecipient>
<participant typeCode="IND">
<templateId root="2.16.840.1.113883.10.20.22.5.8" extension="2023-05-01"/>
<associatedEntity classCode="GUAR">
<code nullFlavor="NA"/>
<addr>
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<associatedPerson>
<name>
<family>Newman</family>
<given>Alice</given>
<given>Jones</given>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<participant typeCode="IND">
<templateId root="2.16.840.1.113883.10.20.22.5.8" extension="2023-05-01"/>
<associatedEntity classCode="PRS">
<code code="GRPRN" codeSystem="2.16.840.1.113883.5.111"/>
<addr>
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom value="mailto:Y...@test.com"/>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<associatedPerson>
<name>
<family>Holler</family>
<given>Rick</given>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<participant typeCode="IND">
<templateId root="2.16.840.1.113883.10.20.22.5.8" extension="2023-05-01"/>
<associatedEntity classCode="PRS">
<code code="SPS" codeSystem="2.16.840.1.113883.5.111"/>
<addr>
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom value="mailto:Y...@test.com"/>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<associatedPerson>
<name>
<family>Newman</family>
<given>Matthew</given>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<documentationOf>
<serviceEvent classCode="PCPR">
<id root="1.3.6.1.4.1.22812.11.2021.1.3.8" extension="1000013557"/>
<code code="EMER" codeSystem="2.16.840.1.113883.5.4"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20220317135500+0000"/>
<high value="20220318035900+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<assignedEntity>
<id extension="205301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<id extension="2222222541" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine>123 First St</streetAddressLine>
<streetAddressLine nullFlavor="UNK"/>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>USA</country>
</addr>
<assignedPerson>
<name>
<family>Davis</family>
<given>Albert</given>
<suffix>Physician</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<performer typeCode="PRF">
<assignedEntity>
<id extension="219301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<code code="163W00000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine>123 First St</streetAddressLine>
<streetAddressLine nullFlavor="UNK"/>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>USA</country>
</addr>
<assignedPerson>
<name>
<family>Davis</family>
<given>Tracy</given>
<suffix>ADM Nurse</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<performer typeCode="PRF">
<assignedEntity>
<id extension="18201190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<id extension="4987042619" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine>123 First St</streetAddressLine>
<streetAddressLine nullFlavor="UNK"/>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>USA</country>
</addr>
<telecom value="mailto:ab...@gmail.com"/>
<assignedPerson>
<name>
<family>Abc</family>
<given>xyz</given>
<suffix>MD</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>
<componentOf>
<encompassingEncounter>
<id root="1.3.6.1.4.1.22812.11.2021.1.3.4" extension="1000013557"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20220317135500+0000"/>
<high value="20220318035900+0000"/>
</effectiveTime>
</encompassingEncounter>
</componentOf>
<component>
<structuredBody>
<component>
<section>
<templateId root="2.16.840.1.113883.3.3251.1.5"/>
<templateId root="2.16.840.1.113883.3.3251.1.10"/>
<code code="57017-6" codeSystem="2.16.840.1.113883.6.1"/>
<title>Privacy Markings</title>
<text>
<list>
<caption styleCode="Bold"/>
<item>
<content styleCode="xSecondary">Section Author: ProviderOne, One
PROHIBITION ON REDISCLOSURE OF CONFIDENTIAL INFORMATION
This notice accompanies a disclosure of information concerning a
client made to you with the consent of such client. This information has
been disclosed to you from records protected by federal confidentiality
rules (42 C.F.R. Part 2). The federal rules prohibit you from making any
further disclosure of this information unless further disclosure is
expressly permitted by the written consent of the person to whom it
pertains or as otherwise permitted by 42 C.F.R. Part 2. A general
authorization for the release of medical or other information is NOT
sufficient for this purpose.
</content>
</item>
</list>
</text>
<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
<entry typeCode="COMP">
<templateId root="2.16.840.1.113883.3.3251.1.9"/>
<organizer classCode="CLUSTER" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.3251.1.4"/>
<statusCode code="active"/>
<component typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.445.21"/>
<templateId root="2.16.840.1.113883.3.445.12"/>
<code code="SECCLASSOBS" codeSystem="2.16.840.1.113883.1.11.20471"/>
<value xsi:type="CE" code="N" codeSystem="2.16.840.1.113883.5.25"/>
</observation>
</component>
<component typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.445.21"/>
<templateId root="2.16.840.1.113883.3.445.14"/>
<code code="SECCONOBS" codeSystem="2.16.840.1.113883.1.11.20457"/>
<value xsi:type="CE" code="AUDIT" codeSystem="2.16.840.1.113883.5.4"/>
</observation>
</component>
<component typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.445.21"/>
<templateId root="2.16.840.1.113883.3.445.23"/>
<code code="SECCONOBS" codeSystem="2.16.840.1.113883.1.11.20457"/>
<value xsi:type="CE" code="NOREUSE" codeSystem="2.16.840.1.113883.5.4"/>
</observation>
</component>
<component typeCode="COMP">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.445.21"/>
<templateId root="2.16.840.1.113883.3.445.22"/>
<code code="SECCONOBS" codeSystem="2.16.840.1.113883.1.11.20457"/>
<value xsi:type="CE" code="TREAT" codeSystem="2.16.840.1.113883.5.8"/>
</observation>
</component>
</organizer>
</entry>
</section>
</component>
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.65" extension="2016-11-01"/>
<code code="34109-9" codeSystem="2.16.840.1.113883.6.1"/>
<title>Note</title>
<text>
<table>
<colgroup>
<col width="95%"/>
</colgroup>
<tbody styleCode="xRowGroup" ID="_66dafc89-700f-4250-882a-47883f57591b">
<tr>
<td>
<content>23-Jul-2025 9:17</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_a9c7b6c3-0499-4860-917e-a8131cac0bc3">
Procedure Notes Results [Date of Service: 23-Jul-2025 09:17, Authored:
23-Jul-2025 09:17]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the breathlessness is due to high fever and anxiety
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_fde23021-3ea1-4115-b294-6d37c224072c">
<tr>
<td>
<content>28-Mar-2025 16:34</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_104bbdec-251f-4364-a9cb-28e02165dce1">
Procedure Notes Results [Date of Service: 28-Mar-2025 16:34, Authored:
28-Mar-2025 16:34]- for Visit: 1000013557, Complete, Entered, Signed in
Full, Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the breathlessness is due to high fever and anxiety
Electronic Signatures:
test, John (MD) (Signed 28-Mar-2025 16:34)
Authored: PROCEDURE NOTE RESULTS
Last Updated: 28-Mar-2025 16:34 by test, John (MD)
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_da24f818-d44b-44ee-81ff-08008491d7c9">
<tr>
<td>
<content>17-Mar-2022 13:15</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_ff6e5607-b0b2-47e4-b061-13a835cff953">
Procedure Notes Results [Date of Service: 17-Mar-2022 13:15, Authored:
17-Mar-2022 13:15]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the
breathlessness is due to high fever and anxiety.
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_62e17da4-b7df-4ceb-b9b9-4f3165f5a9a3">
<tr>
<td>
<content>22-Jun-2015 11:55</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_736c12bd-418e-4ec6-951a-8b7194633723">
Procedure Notes Results [Date of Service: 22-Jun-2015 11:55, Authored:
18-Mar-2022 11:55]- for Visit: 1000013557, Complete, Revised, Signed in
Full, Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the
breathlessness is due to high fever and anxiety
Electronic Signatures:
Last Updated: 24-Jul-2023 12:07 by test, John (MD)
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_c3572c57-e4ce-415b-9b21-7f026a8e3228">
<tr>
<td>
<content>23-Jul-2025 9:24</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_7aa37f31-fdd5-4be3-9ab4-cb52250dc499">
Progress Note, Adult [Date of Service: 23-Jul-2025 09:24, Authored:
23-Jul-2025 09:24]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
Reason for Admission/Subjective:
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_6e1909cd-c1dc-40ab-ba68-e3699b7d5cfe">
<tr>
<td>
<content>23-Jul-2025 7:21</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_5c14191a-313e-4093-a976-41e8ca1e7835">
Progress Note, Adult [Date of Service: 23-Jul-2025 07:21, Authored:
23-Jul-2025 07:21]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
Reason for Admission/Subjective:
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral.
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
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Progress Note, Adult [Date of Service: 23-Jul-2025 07:14, Authored:
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Available to Patient
Reason for Admission/Subjective:
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral.
Electronic Signatures:
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Progress Note, Adult [Date of Service: 23-Jul-2025 07:11, Authored:
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Available to Patient
Reason for Admission/Subjective:
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· Subjective Ms Alice Newman seems to be developing high fever and hence we
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Electronic Signatures:
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Progress Note, Adult [Date of Service: 28-Mar-2025 16:37, Authored:
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Full, Available to Patient
Reason for Admission/Subjective:
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· Reason for Admission Progress Note - high fever
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral.
Electronic Signatures:
test, John (MD) (Signed 28-Mar-2025 16:37)
Authored: Reason for Admission/Subjective
Last Updated: 28-Mar-2025 16:37 by test, John (MD)
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· Reason for Admission Progress note - high fever
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a
nearby hospital using the provided referral.
Electronic Signatures:
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<title>Allergies and Adverse Reactions</title>
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<td>
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<br/>
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<td>
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<td>
<content styleCode="xContentWrapping">
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<br/>
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<content styleCode="xSecondary">2</content>
<content styleCode="xSecondary">, Immuno-U.S., Inc.</content>
<br/>
</content>
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<td>
<content styleCode="xLabel">On: </content>
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<col width="20%"/>
<col width="40%"/>
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<td>
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<td/>
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<table>
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<col width="40%"/>
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<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr>
<td>
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<td>
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5:08</content>
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<td/>
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<tr>
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3:38</content>
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<tbody styleCode="xRowGroup">
<tr>
<td>
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<td>
<content styleCode="xSecondary">24-Jul-2025
5:11</content>
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<tr>
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<td>
<content styleCode="xSecondary">24-Jul-2025
5:11</content>
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<table>
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<td>
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<br/>
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<content styleCode="xSecondary"/>
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<td/>
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<col width="40%"/>
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<tr>
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<td>
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<content ID="_8a084fec-0e8c-43b6-ac2f-4649fd73f380">Goals to address Health
Concerns</content>
</td>
<td>
<content styleCode="xLabel">Start: </content>
<content>28-Mar-2025</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Status: </content>
<content>Active</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_e4b1a707-3929-4bbb-8719-ac31d71e714b">
<tr>
<td>
<content/>
<content ID="_d2351567-7a27-4f64-9d7d-e529a4025103">Healthcare concerns
refer to underlying clinical facts</content>
</td>
<td>
<content styleCode="xLabel">Start: </content>
<content>28-Mar-2022</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Status: </content>
<content>Aborted</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_d61cf626-5c4b-45f6-8a36-717e5dd8875f">
<tr>
<td>
<content/>
<content ID="_aa1a9c4a-5183-4279-8bee-7919c7874d7b">Chronic Sickness
exhibited by patient</content>
</td>
<td>
<content styleCode="xLabel">Start: </content>
<content>28-Mar-2025</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Status: </content>
<content>Active</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_eda6de86-570b-4b34-9636-28dded24b468">
<tr>
<td>
<content/>
<content ID="_65f25303-af57-43ef-8c03-5f4ce99adf82">Food
insecurity</content>
</td>
<td>
<content styleCode="xLabel">Start: </content>
<content>12-Aug-2025</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Status: </content>
<content>Active</content>
<br/>
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<tr>
<td colspan="3">
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</td>
</tr>
<tr ID="_092d9f77-f813-4193-b03a-f5f8ca86de61">
<td>
<content styleCode="xIndent"> •</content>
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<td>
<content styleCode="xLabel xSecondary">Onset: </content>
<content styleCode="xSecondary">22-Jun-2015</content>
<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Status: </content>
<content styleCode="xSecondary">Complete</content>
</td>
</tr>
<tr ID="_e850836a-59d2-4046-b100-db4bb92e4739">
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xContentWrapping">
<content styleCode="xSecondary"> SdohHealthConcern</content>
</content>
</td>
<td>
<content styleCode="xSecondary">12-Aug-2025 03:38</content>
</td>
<td/>
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<tr ID="_ecd0af3a-b3af-473d-bb48-7455547ff646">
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xContentWrapping">
<content styleCode="xLabel xSecondary">Home Environment: </content>
<content styleCode="xSecondary"
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</content>
</td>
<td>
<content styleCode="xSecondary">12-Aug-2025
3:38</content>
</td>
<td/>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_9e06f082-525f-48ee-a9dd-202dc643ee30">
<tr>
<td>
<content/>
<content ID="_f6f17929-086e-441f-b9a5-f8f08db86d9e">Sickness</content>
</td>
<td>
<content styleCode="xLabel">Start: </content>
<content>22-Jun-2015</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Status: </content>
<content>Active</content>
<br/>
</td>
</tr>
<tr>
<td colspan="3">
<content styleCode="Italics">Related To: </content>
</td>
</tr>
<tr ID="_45548712-3339-46ce-93fe-d4c6d74b4b79">
<td>
<content styleCode="xIndent"> •</content>
<content ID="_f3f0d545-370f-48c2-ba02-a4fb804782af" styleCode="xSecondary
xContentWrapping">Sickness</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Onset: </content>
<content styleCode="xSecondary">22-Jun-2015</content>
<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Status: </content>
<content styleCode="xSecondary">Complete</content>
</td>
</tr>
<tr ID="_c0907e81-6e19-4f16-aba5-ad42321b75c6">
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xContentWrapping"/>
</td>
<td>
<content styleCode="xSecondary">22-Jun-2015</content>
</td>
<td/>
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</tbody>
<tbody styleCode="xRowGroup" ID="_0146282a-5268-4584-8433-06edde239e6c">
<tr>
<td>
<content/>
<content ID="_13e72585-b7dd-454a-af98-be2752bb4b85">HealthCare Concerns
refer to underlying clinical</content>
</td>
<td>
<content styleCode="xLabel">Start: </content>
<content>28-Mar-2025</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Status: </content>
<content>Active</content>
<br/>
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</tr>
<tr>
<td colspan="3">
<content styleCode="Italics">Related To: </content>
</td>
</tr>
<tr ID="_821bb69c-45fa-4d8d-b84e-79fb0e2452f3">
<td>
<content styleCode="xIndent"> •</content>
<content ID="_b3ebabb1-aa79-4b3d-9ae5-0c3625204fd3" styleCode="xSecondary
xContentWrapping">Essential hypertension</content>
</td>
<td/>
<td>
<content styleCode="xLabel xSecondary">Status: </content>
<content styleCode="xSecondary">Complete</content>
</td>
</tr>
<tr ID="_9e218559-f729-46b3-a738-436ff762faa5">
<td>
<content styleCode="xIndent"> •</content>
<content ID="_1df441c7-0647-4c79-8334-5a288f04ef24" styleCode="xSecondary
xContentWrapping">Severe hypothyroidism</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Onset: </content>
<content styleCode="xSecondary">31-Dec-2006</content>
<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Status: </content>
<content styleCode="xSecondary">Complete</content>
</td>
</tr>
<tr ID="_3c325f9d-3d25-4354-8dce-76ed89818980">
<td>
<content styleCode="xIndent"> •</content>
<content ID="_2d7dbec8-5603-4e63-b1c6-90877c1baafb" styleCode="xSecondary
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</td>
<td/>
<td>
<content styleCode="xLabel xSecondary">Status: </content>
<content styleCode="xSecondary">Complete</content>
</td>
</tr>
</tbody>
</table>
<list>
<caption styleCode="xSectionComments Bold">Section Comments</caption>
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<text>
<reference value="#_1573fccb-8db7-4821-a5b0-820646c035d7"/>
</text>
<statusCode code="completed"/>
<effectiveTime nullFlavor="NI"/>
<value xsi:type="CD" nullFlavor="NI">
<originalText>
<reference value="#_807e773b-89c0-45b4-91df-bfe984f00803"/>
</originalText>
</value>
</observation>
</entryRelationship>
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</entry>
</section>
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<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.41"/>
<code code="8653-8" codeSystem="2.16.840.1.113883.6.1"/>
<title>Hospital Discharge Instructions</title>
<text>
<list>
<caption styleCode="Bold"/>
<item>
<content styleCode="xSecondary">Hospital Discharge Instructions
excluded/not available</content>
</item>
</list>
</text>
</section>
</component>
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.23" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.2.23"/>
<code code="46264-8" codeSystem="2.16.840.1.113883.6.1"/>
<title>Medical Equipment</title>
<text>
<table>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr ID="_50f90805-fc24-40a8-96d1-02f95ed1e913">
<td>
<content styleCode="xContentWrapping"
ID="_a9e42af9-d4b5-4b15-9294-96a024c86e79">Cardiac resynchronization
therapy implantable defibrillator</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Date: </content>
<content styleCode="xSecondary ">28-Mar-2022</content>
<br/>
</td>
<td/>
</tr>
<tr ID="_06b99da1-766c-4a2e-961f-29972676837d">
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xContentWrapping">
<content ID="_a32c45a4-6ad4-4d99-a710-4032ca965c14">Viva™ Quad XT
CRT-D</content>
<br/>
<content ID="_aa93cb04-cf0a-41f7-ad94-a70b6e376989">MEDTRONIC,
INC.</content>
<br/>
<content>(FDA) 1.3.160 00643169007222</content>
<br/>
<content styleCode="xLabel">Serial: </content>
<content ID="_2540915a-049b-42b2-8937-b74571769ffa">BLC200461H</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Expires: </content>
<content>28-Jan-2016</content>
<br/>
<content styleCode="xLabel">Model: </content>
<content ID="_aadab885-47db-40df-ba83-083ccb4d3696">DTBA1QQ</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Implant Status: </content>
<content>Implanted</content>
<br/>
<content styleCode="xLabel">MRI: </content>
<content styleCode="xAlert">Labeling does not contain MRI Safety
information</content>
<br/>
<content styleCode="xLabel">Latex: </content>
<content>Not made with natural Rubber Latex</content>
<br/>
</td>
</tr>
</tbody>
</table>
</text>
<entry>
<procedure classCode="PROC" moodCode="EVN">
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<originalText>
<reference value="#_a9e42af9-d4b5-4b15-9294-96a024c86e79"/>
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<text>
<reference value="#_50f90805-fc24-40a8-96d1-02f95ed1e913"/>
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<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20220328040000+0000"/>
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<participant typeCode="DEV">
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<id root="2.16.840.1.113883.3.3719"
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<playingDevice>
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</playingDevice>
<scopingEntity>
<id root="2.16.840.1.113883.3.3719"/>
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<entryRelationship typeCode="COMP">
<organizer classCode="CLUSTER" moodCode="EVN">
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<id root="2.16.840.1.113883.3.3719"
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assigningAuthorityName="FDA"/>
<code code="74711-3" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="completed"/>
<!-- Device Identifier -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.304" extension="2019-06-21"/>
<code code="C101722" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="II" root="1.3.160" extension="00643169007222"
assigningAuthorityName="FDA" displayable="true"/>
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</component>
<!-- Serial Number -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.319" extension="2019-06-21"/>
<code code="C101671" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="ED">
<reference value="#_2540915a-049b-42b2-8937-b74571769ffa"/>
</value>
</observation>
</component>
<!-- Expiration Date -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.309" extension="2019-06-21"/>
<code code="C101670" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="TS" value="20160128050000+0000"/>
</observation>
</component>
<!-- Brand Name -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.301" extension="2019-06-21"/>
<code code="C71898" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="ED">
<reference value="#_a32c45a4-6ad4-4d99-a710-4032ca965c14"/>
</value>
</observation>
</component>
<!-- Model Number -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.317" extension="2019-06-21"/>
<code code="C99285" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="ED">
<reference value="#_aadab885-47db-40df-ba83-083ccb4d3696"/>
</value>
</observation>
</component>
<!-- Company Name -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.303" extension="2019-06-21"/>
<code code="C54131" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="ED">
<reference value="#_aa93cb04-cf0a-41f7-ad94-a70b6e376989"/>
</value>
</observation>
</component>
<!-- Latex Safety -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.314" extension="2019-06-21"/>
<code code="C160938" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="CD" code="C106038"
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</component>
<!-- MRI Safety Status -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.318" extension="2019-06-21"/>
<code code="C106044" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="CD" code="C113844"
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</component>
<!-- Device Status Implanted -->
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.305" extension="2019-06-04"/>
<code code="C160939" codeSystem="2.16.840.1.113883.3.26.1.1"/>
<value xsi:type="CD" code="Implanted">
<originalText>Implanted</originalText>
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</procedure>
</entry>
</section>
</component>
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.10" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.2.10"/>
<code code="18776-5" codeSystem="2.16.840.1.113883.6.1"/>
<title>Plan of Treatment</title>
<text>
<table>
<caption>Goals</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup" ID="_314fe093-b2e9-460c-9f0d-0ae367472c2c">
<tr>
<td>
<content ID="_062d2302-b227-423a-ba5e-4db9970e0e36">Planning Goal: Address
anemia</content>
</td>
<td/>
<td/>
</tr>
</tbody>
</table>
<table>
<caption>Planned Immunizations</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr ID="_4acd0d92-eb9a-46e5-a829-fae26cc87de7">
<td>
<content styleCode="xContentWrapping">
<content ID="_e8341bcf-7de6-475f-9c38-78ff536b5043">Anthrax</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_9b5b6951-2102-4130-972f-fbcde8f7c4b9">
<td>
<content styleCode="xContentWrapping">
<content ID="_676af552-7e11-41bf-adab-3f09d08bf7da">Bacillus
Calmette-Guerin (BCG)</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_b0376ec3-0bba-425b-a320-9b7634533fbb">
<td>
<content styleCode="xContentWrapping">
<content ID="_3761e83e-f3f3-4a32-a1b0-ad0eadb9d859">Hepatitis A</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_bd316335-e045-45c0-a2e5-4ba90b793e44">
<td>
<content styleCode="xContentWrapping">
<content ID="_9def68de-b91f-4e17-82ce-96936b179497">Human Papilloma Virus
(HPV)</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_d48bcc2f-f3b3-4ee1-b980-355d29a2b66e">
<td>
<content styleCode="xContentWrapping">
<content ID="_f66ad55d-f424-44f0-9844-91841ea5816e">Influenza</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_f9e85003-32cd-4741-b284-682c1ddd3227">
<td>
<content styleCode="xContentWrapping">
<content ID="_892ad540-a220-4a6c-b442-de2c64ebe691">Tetanus</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_f0dd1f14-832f-4cf1-826c-3f6e87650fbd">
<td>
<content styleCode="xContentWrapping">
<content ID="_2a07172d-0af5-430f-b192-7ed5581205f4">Tdap</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_a54e28f9-8ca5-4f2f-b344-b5a984aca95e">
<td>
<content styleCode="xContentWrapping">
<content ID="_bd6d4435-1b75-4ff7-bbb1-8e3ff03e88dd">Varicella</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_c4f3b6a8-9d20-44a1-ab2e-24069cea8c38">
<td>
<content styleCode="xContentWrapping">
<content ID="_95d6541f-82ba-46e4-8f25-f527c2acda60">Coronavirus
(COVID-19)</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
</table>
<table>
<caption>Planned Procedures</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup" ID="_08d044b8-4d6e-482e-b733-be3b505e1ef0">
<tr>
<td>
<content styleCode="xContentWrapping"
ID="_cf2fc628-871a-4129-8920-44d0b47859f0">Order_Procedure_SDOH</content>
</td>
<td/>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_24dc0334-d029-4fe4-adbc-ffb6ab8ea0eb">
<tr>
<td>
<content styleCode="xContentWrapping"
ID="_d4125b73-1841-40d6-b75f-e56cd1fc9c8a">Assistance with application for
food pantry program</content>
</td>
<td/>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_09ad177e-8962-41fc-8c52-75e7c1da4ede">
<tr>
<td>
<content styleCode="xContentWrapping"
ID="_24063878-7769-4f6a-ac48-d4f58dcaa8f5">Future Procedure List:
EKG</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">23-Jun-2015</content>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_225026d0-4963-49f8-b56e-05778b96e3d5">
<tr>
<td>
<content styleCode="xContentWrapping"
ID="_86d0394e-af91-4556-8a39-7fc632520ab3">Future Procedure Text:
EKG</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">23-Jun-2015</content>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
</table>
<table>
<caption>Planned Encounters</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
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<td>
<content styleCode="xContentWrapping">
<content ID="_3e7f66a3-4b2b-41d0-b5b4-f34a7cf45d5d">Future Encounters Text:
i. Get an EKG done on 6/23/2015.
ii. Get a Chest X-ray done on 6/23/2015 showing the Lower Respiratory Tract
Structure.
iii. Take Clindamycin 300mg three times a day as needed if pain does not
subside.
iv. Schedule follow on visit with Neighborhood Physicians Practice on
7/1/2015. </content>
<br/>
<content styleCode="xSecondary"/>
</content>
</td>
<td/>
<td>
<content>Intent </content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_f501e8a1-7fed-46e8-a070-3ab0fb564838">
<td>
<content styleCode="xContentWrapping">
<content ID="_bb21b344-de7f-4177-a666-392fd9e1cc8f">Future Encounters Text:
Get an EKG done on 6/23/2015.
Get a Chest X-ray done on 6/23/2015 showing the Lower Respiratory Tract
Structure.
Take Clindamycin 300mg three times a day as needed if pain does not subside/
Schedule follow on visit with Neighborhood Physicians Practice on
7/1/2015.
</content>
<br/>
<content styleCode="xSecondary"/>
</content>
</td>
<td/>
<td>
<content>Intent </content>
<br/>
</td>
</tr>
</tbody>
</table>
<table>
<caption>Planned Observations</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr ID="_e26e54d7-1744-449a-8ae0-b811461d8702">
<td>
<content ID="_94ced7fe-006c-4f0c-8bbc-77161a13b10d">Urinalysis macro
(dipstick) panel</content>
<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">31-Aug-2025
0:00</content>
<br/>
</td>
<td>
<content>Request</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_17cf2e6d-3da0-4d03-8e26-bc06546a7bce">
<td>
<content ID="_2b30833f-2d7b-4c5f-accb-263d03a742db">EKG</content>
<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">31-Jul-2025
0:00</content>
<br/>
</td>
<td>
<content>Request</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_d155b16e-4602-4a84-8b7d-ae2ef6c0b99c">
<td>
<content ID="_e70163d8-a992-41db-98af-4dba2b6b5fbd">Urinalysis macro
(dipstick) panel</content>
<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">25-Aug-2025
0:00</content>
<br/>
</td>
<td>
<content>Request</content>
</td>
</tr>
</tbody>
</table>
<table>
<caption>Instructions</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr ID="_5535534c-fe97-4da3-9c2c-5a38d7219aae">
<td>
<content styleCode="xContentWrapping">
<content>Planning Goal Instructions Text: a. Get rid of intermittent fever
that is occurring every few weeks.</content>
<br/>
</content>
</td>
<td/>
<td>
<content styleCode="xLabel">Instruction Type: </content>
<content
ID="_d61694c9-2ca6-47d0-a8bb-0299d051117b">Self-carePatientEducation</content>
<br/>
</td>
</tr>
</tbody>
</table>
</text>
<entry>
<observation classCode="OBS" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.44" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.44"/>
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<text>
<reference value="#_e26e54d7-1744-449a-8ae0-b811461d8702"/>
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<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250831040000+0000"/>
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<author>
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<assignedAuthor>
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<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
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<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
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<entry>
<observation classCode="OBS" moodCode="RQO">
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<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
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<telecom nullFlavor="UNK"/>
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</author>
<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
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<entry>
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<templateId root="2.16.840.1.113883.10.20.22.4.44"/>
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<time value="20250725071847+0000"/>
<assignedAuthor>
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<addr>
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<state nullFlavor="UNK"/>
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<telecom nullFlavor="UNK"/>
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</author>
<entryRelationship typeCode="SUBJ">
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<templateId root="2.16.840.1.113883.10.20.22.4.40"/>
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<entry>
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<templateId root="2.16.840.1.113883.10.20.22.4.40"/>
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<statusCode code="active"/>
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<entry>
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<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.7" extension="23912000680"/>
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<originalText>
<reference value="#_cf2fc628-871a-4129-8920-44d0b47859f0"/>
</originalText>
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<text>
<reference value="#_08d044b8-4d6e-482e-b733-be3b505e1ef0"/>
</text>
<statusCode code="active"/>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20250724075504+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
<entryRelationship typeCode="RSON">
<observation classCode="OBS" moodCode="EVN">
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<templateId root="2.16.840.1.113883.10.20.22.4.69"/>
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<value xsi:type="ST" nullFlavor="NI"/>
<author>
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<time value="20250724075504+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
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<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
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</encounter>
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</observation>
</entryRelationship>
<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
<id root="1.3.6.1.4.1.22812.11.2021.1.3.4" extension="1000013557"/>
</encounter>
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<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.7" extension="23918000680"/>
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<originalText>
<reference value="#_d4125b73-1841-40d6-b75f-e56cd1fc9c8a"/>
</originalText>
</code>
<text>
<reference value="#_24dc0334-d029-4fe4-adbc-ffb6ab8ea0eb"/>
</text>
<statusCode code="active"/>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20250807071657+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
<entryRelationship typeCode="RSON">
<observation classCode="OBS" moodCode="EVN">
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<templateId root="2.16.840.1.113883.10.20.22.4.69"/>
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<effectiveTime value="20250807031657"/>
<value xsi:type="ST" nullFlavor="NI"/>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20250807071657+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
<id root="1.3.6.1.4.1.22812.11.2021.1.3.4" extension="1000013557"/>
</encounter>
</entryRelationship>
</observation>
</entryRelationship>
<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
<id root="1.3.6.1.4.1.22812.11.2021.1.3.4" extension="1000013557"/>
</encounter>
</entryRelationship>
</procedure>
</entry>
<entry>
<procedure classCode="PROC" moodCode="RQO">
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<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.7" extension="INT"/>
<code code="102594003" codeSystem="2.16.840.1.113883.6.5">
<originalText>
<reference value="#_24063878-7769-4f6a-ac48-d4f58dcaa8f5"/>
</originalText>
</code>
<text>
<reference value="#_09ad177e-8962-41fc-8c52-75e7c1da4ede"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20150623040000+0000"/>
</effectiveTime>
</procedure>
</entry>
<entry>
<procedure classCode="PROC" moodCode="RQO">
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<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.7" extension="INT"/>
<code nullFlavor="NI">
<originalText>
<reference value="#_86d0394e-af91-4556-8a39-7fc632520ab3"/>
</originalText>
</code>
<text>
<reference value="#_225026d0-4963-49f8-b56e-05778b96e3d5"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20150623040000+0000"/>
</effectiveTime>
</procedure>
</entry>
<entry>
<act classCode="ACT" moodCode="INT">
<templateId root="2.16.840.1.113883.10.20.22.4.20" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.20"/>
<code code="Self-carePatientEducation" codeSystem="2.16.840.1.113883.6.96">
<originalText>
<reference value="#_d61694c9-2ca6-47d0-a8bb-0299d051117b"/>
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<text>
<reference value="#_5535534c-fe97-4da3-9c2c-5a38d7219aae"/>
</text>
<statusCode code="completed"/>
</act>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32047"/>
<text>
<reference value="#_4acd0d92-eb9a-46e5-a829-fae26cc87de7"/>
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<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
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<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
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<lotNumberText nullFlavor="NI"/>
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<manufacturerOrganization>
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</consumable>
<author>
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<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
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</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32045"/>
<text>
<reference value="#_9b5b6951-2102-4130-972f-fbcde8f7c4b9"/>
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<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
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<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
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<reference value="#_676af552-7e11-41bf-adab-3f09d08bf7da"/>
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<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Sanofi Pasteur</name>
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</manufacturedProduct>
</consumable>
<author>
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<time value="20220317170318+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
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<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
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<telecom nullFlavor="UNK"/>
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</author>
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</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32042"/>
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<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
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<manufacturedMaterial>
<code code="83" codeSystem="2.16.840.1.113883.12.292">
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<reference value="#_3761e83e-f3f3-4a32-a1b0-ad0eadb9d859"/>
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<lotNumberText nullFlavor="NI"/>
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<manufacturerOrganization>
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</manufacturedProduct>
</consumable>
<author>
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<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
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<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
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</author>
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</entry>
<entry>
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<statusCode code="active"/>
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<manufacturedMaterial>
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<author>
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<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
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<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
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</author>
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</entry>
<entry>
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<manufacturedMaterial>
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</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>bioCSL</name>
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</manufacturedProduct>
</consumable>
<author>
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<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
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</author>
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</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<statusCode code="active"/>
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<lotNumberText nullFlavor="NI"/>
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<author>
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<time value="20220318191258+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
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<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="115" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_2a07172d-0af5-430f-b192-7ed5581205f4"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Sanofi Pasteur</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20220317170318+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<name>Merck &Co., Inc.</name>
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<code code="30954-2" codeSystem="2.16.840.1.113883.6.1"/>
<title>Results</title>
<text>
<table>
<colgroup>
<col width="20%"/>
<col width="40%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr>
<td>
<content styleCode="xSecondary"
ID="_98e020e5-51c6-4e8b-ac2f-daf2138a8dda">Urinalysis macro (dipstick)
panel</content>
</td>
<td>
<content styleCode="xLabel">Ordered On: </content>
<content>12-Aug-2025
6:58</content>
</td>
<td/>
</tr>
<tr ID="_6e3d1e62-6de0-454c-b54e-2ed98e9fedcb">
<td>
<content styleCode="xSecondary xContentWrapping">12-Aug-2025 7:01</content>
</td>
<td>
<content styleCode="xSecondary"
ID="_c501df0c-433c-47c4-b1f9-5e4fe3ba4dfc">Urine Specific Gravity</content>
<content styleCode="xSecondary"> 1.015</content>
<content styleCode="xSecondary"> {Unit(s)}</content>
</td>
<td>
<content ID="_ef2fbcf2-a7fc-456d-aa42-0e3053a48382">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 1.005 - 1.030 Unit(s)</content>
<br/>
</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xLabel xSecondary">Specimen Type: </content>
<content styleCode="xSecondary xContentWrapping">Urinary specimen
(specimen)</content>
<br/>
</td>
<td/>
<td/>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr>
<td>
<content styleCode="xSecondary"
ID="_59802fe7-923d-4141-a4f8-3f24d0746599">Urine Dipstick, POCT</content>
</td>
<td>
<content styleCode="xLabel">Ordered On: </content>
<content>21-Mar-2022
13:56</content>
</td>
<td/>
</tr>
<tr ID="_991912f0-35c9-4c98-bb2a-89107629e8cb">
<td>
<content styleCode="xSecondary xContentWrapping">21-Mar-2022 13:56</content>
</td>
<td>
<content styleCode="xSecondary"
ID="_dd375862-d97d-48fe-b117-91f6e64892b0">Urine Glucose</content>
<content styleCode="xSecondary"> 50 mg/dL</content>
</td>
<td>
<content ID="_0f82695e-3acb-457e-adbc-943c2fb4936c">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Neg</content>
<br/>
</content>
</td>
</tr>
<tr ID="_c7e894bf-71ea-498f-a4a7-231122bc26eb">
<td/>
<td>
<content styleCode="xSecondary"
ID="_e3dd466b-8d14-44f6-8a31-21a23da7cd83">Ketones</content>
<content styleCode="xSecondary"> Negative</content>
</td>
<td>
<content ID="_720c7c9a-7bff-4ab2-b125-26f1eb71cf90">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Negative</content>
<br/>
</content>
</td>
</tr>
<tr ID="_4889d501-9e1e-4938-a4cf-b4a6dd5d7a7a">
<td/>
<td>
<content styleCode="xSecondary"
ID="_f922259e-b01c-4be7-8d8b-9f7bf5394a42">Protein</content>
<content styleCode="xSecondary"> 100 mg/dL</content>
</td>
<td/>
</tr>
<tr ID="_48309965-3a20-4450-b550-186cddf19913">
<td/>
<td>
<content styleCode="xSecondary"
ID="_54498502-58c7-4526-a70d-25a17a19c626">Urine Specific Gravity</content>
<content styleCode="xSecondary"> 1.015</content>
</td>
<td>
<content ID="_b49c40eb-368d-4b02-93dd-b90860999ebd">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 1.005 - 1.030</content>
<br/>
</content>
</td>
</tr>
<tr ID="_4d2bb956-aede-42a0-8f8e-e14310449a49">
<td/>
<td>
<content styleCode="xSecondary"
ID="_836edce4-a925-4030-92a6-cb32c60c74e7">Urine pH</content>
<content styleCode="xSecondary"> 5.0</content>
</td>
<td>
<content ID="_92d33752-942d-448a-9617-8fa841ea48a6">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 5.0 - 8.0</content>
<br/>
</content>
</td>
</tr>
<tr ID="_cc205f5f-f1f7-47fc-b69d-1f37288de8d6">
<td/>
<td>
<content styleCode="xSecondary"
ID="_fcb8b951-d209-45df-972c-0b0539ca8fe1">Color</content>
<content styleCode="xSecondary"> Yellow</content>
</td>
<td>
<content ID="_0c086479-56d6-4284-861f-91179d7836ac">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Yellow</content>
<br/>
</content>
</td>
</tr>
<tr ID="_f113fc20-16eb-4435-b6c0-a438e9740bf4">
<td/>
<td>
<content styleCode="xSecondary"
ID="_7c36e5f1-ccba-4542-a6fb-ef92dc718faa">Urine Appearance</content>
<content styleCode="xSecondary"> Clear</content>
</td>
<td>
<content ID="_778e3210-0952-431f-8c15-06c139f9301c">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Clear</content>
<br/>
</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xLabel xSecondary">Specimen Type: </content>
<content styleCode="xSecondary xContentWrapping">Urinary specimen
(specimen)</content>
<br/>
</td>
<td/>
<td/>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr>
<td>
<content styleCode="xSecondary"
ID="_849ab527-7cab-4c7e-ba75-5f2b5729d9a6">Urinalysis macro (dipstick)
panel</content>
</td>
<td>
<content styleCode="xLabel">Ordered On: </content>
<content>17-Mar-2022
13:38</content>
</td>
<td/>
</tr>
<tr ID="_67d176bf-2b5d-4155-a87c-5b545b506cd0">
<td>
<content styleCode="xSecondary xContentWrapping">17-Mar-2022 16:02</content>
</td>
<td>
<content styleCode="xSecondary"
ID="_0a0f4cc4-87e0-4888-b79c-0296c75f339d">Urine Appearance</content>
<content styleCode="xSecondary"> Clear</content>
</td>
<td>
<content ID="_e82d5d0e-e75b-4a18-b8ff-d940d664a3ac">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Clear</content>
<br/>
</content>
</td>
</tr>
<tr ID="_e82a0fd1-5eba-467b-94b2-a4eefddc14cf">
<td/>
<td>
<content styleCode="xSecondary"
ID="_3c5e7a84-3ff4-4410-b7c9-390c91ac2c75">Color</content>
<content styleCode="xSecondary"> YELLOW</content>
</td>
<td>
<content ID="_6bc348e9-917c-47fe-99ee-1955fb96099b">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> YELLOW</content>
<br/>
</content>
</td>
</tr>
<tr ID="_38fa361d-a1d6-4d99-a204-04139aed0513">
<td/>
<td>
<content styleCode="xSecondary"
ID="_ccae3039-f4a7-42ec-a97f-4cce53a83261">Urine Glucose</content>
<content styleCode="xSecondary"> 50</content>
<content styleCode="xSecondary"> mg/dL</content>
</td>
<td>
<content ID="_7b4aaa64-679b-45dd-95af-49b9c6582a97">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Neg mg/dL</content>
<br/>
</content>
</td>
</tr>
<tr ID="_e7aa3af6-a797-41ef-9a01-2407d003ece7">
<td/>
<td>
<content styleCode="xSecondary"
ID="_7fa7f1a9-f2fd-46e7-a530-11f5192eb3c3">Ketones</content>
<content styleCode="xSecondary"> Negative</content>
</td>
<td>
<content ID="_2c9499e6-c818-4431-b75e-1818a462109a">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Negative</content>
<br/>
</content>
</td>
</tr>
<tr ID="_7a5e6e48-dfe8-4fa4-b42d-2bf8efeed861">
<td/>
<td>
<content styleCode="xSecondary"
ID="_710762be-44dc-4c65-b3e8-63b172f69e03">Urine Specific Gravity</content>
<content styleCode="xSecondary"> 1.015</content>
</td>
<td>
<content ID="_e8f7f3ed-25fe-4f13-83f8-4129a3da9c71">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 1.005 - 1.030</content>
<br/>
</content>
</td>
</tr>
<tr ID="_049a8153-7c1a-4f33-9e38-be9caf971d73">
<td/>
<td>
<content styleCode="xSecondary"
ID="_7b4664e8-d850-49ba-a3ef-83a2cf17af03">Urine pH</content>
<content styleCode="xSecondary"> 5.0</content>
<content styleCode="xSecondary"> [pH]</content>
</td>
<td>
<content ID="_5c9b91c1-6e77-4236-8e09-1b6f39f956cf">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 5.0 - 8.0 [pH]</content>
<br/>
</content>
</td>
</tr>
<tr ID="_ff7a88da-e971-4887-b888-0acf44cf3549">
<td/>
<td>
<content styleCode="xSecondary"
ID="_86374cd2-bd14-46b8-8985-b83f69d8f088">Protein</content>
<content styleCode="xSecondary"> 100</content>
<content styleCode="xSecondary"> mg/dL</content>
</td>
<td>
<content ID="_a1a3f163-6605-43d4-a993-3989a6cf51f8">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> negative mg/dL</content>
<br/>
</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xLabel xSecondary">Specimen Type: </content>
<content styleCode="xSecondary xContentWrapping">Urinary specimen
(specimen)</content>
<br/>
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<td/>
<td/>
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<statusCode code="completed"/>
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<telecom nullFlavor="UNK"/>
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<value xsi:type="PQ" value="50" unit="mg/dL"/>
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<title>Vital Signs</title>
<text>
<table styleCode="xBorderBottom">
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<col width="20%"/>
<col width="40%"/>
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<tbody styleCode="xRowGroup">
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<td>
<content>11-Mar-2025
12:30</content>
</td>
<td/>
<td/>
</tr>
<tr ID="_0cad1cf9-81d5-4827-93ea-61444e916da4">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_c720c7b6-78ab-4c49-bb78-4c6003c3512d">Heart Rate </content>
<content styleCode="xSecondary">80</content>
<content styleCode="xSecondary"> /min </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_6db72413-d721-4e61-b75f-6b979d2a87c2">High</content>
<content styleCode="xSecondary">)</content>
</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_e65f1d5f-d5b1-491d-8058-a77f4d6aabf4">0 - 9999</content>
</td>
</tr>
<tr ID="_2b07ff4a-ec1b-4a97-af15-ef52ebc9dd06">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_f4dc2fec-0c5a-4775-85bc-286caca8a82c">O2 SAT </content>
<content styleCode="xSecondary">95</content>
<content styleCode="xSecondary"> % </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_716282e4-c605-47f3-b752-91fa0d8eecb9">Normal</content>
<content styleCode="xSecondary">)</content>
</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_d300f985-53ed-4da7-b4f7-b6413dff12f5">0 - 100</content>
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</tr>
<tr ID="_8b573280-9af7-4696-822a-4d92050d9807">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_650bed64-7059-46a4-bb4d-bddf972dbaf1">BP Systolic </content>
<content styleCode="xSecondary">145</content>
<content styleCode="xSecondary"> mm[Hg] </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_b0178184-c99b-4be1-877f-eb0fd1c6cecf">High</content>
<content styleCode="xSecondary">)</content>
</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_bf073fbc-e075-4015-af0e-ac8b16865b4c">0 - 200</content>
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<tr ID="_39c59b25-b0d4-44cb-97c5-175643e966fc">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_5fa47d6c-3175-4f7e-8333-2e9e145c4bbd">BP Diastolic </content>
<content styleCode="xSecondary">88</content>
<content styleCode="xSecondary"> mm[Hg] </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_10720ea2-6b89-4464-87a0-9a07d846c749">High</content>
<content styleCode="xSecondary">)</content>
</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_9533af43-0d29-4dbb-8ff7-fc4fd68c3e8f">0 - 150</content>
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</tr>
<tr ID="_8cbe799b-f482-4c1d-a592-fa782f40f4e1">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_09c1ac4c-d806-4f48-9020-4fce8d637b61">Temperature </content>
<content styleCode="xSecondary">38</content>
<content styleCode="xSecondary"> c </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_d85be691-7ed2-48e8-a803-7f22196e3baa">Normal</content>
<content styleCode="xSecondary">)</content>
</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_6bda3e7a-4f29-47f3-b5da-49bd49e53540">0 - 200</content>
</td>
</tr>
<tr ID="_af8f818a-e2fc-4c69-b990-8f25145d7939">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_5ca693a2-c7fd-4b65-9c2d-389084faca2e">Height </content>
<content styleCode="xSecondary">177</content>
<content styleCode="xSecondary"> cm </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_95b5ac31-5a90-460f-ac90-7e3289732864">High</content>
<content styleCode="xSecondary">)</content>
</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
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<performer typeCode="PRF">
<templateId root="2.16.840.1.113883.10.20.22.4.87"/>
<assignedEntity>
<id extension="2.16.840.1.113883.19"
root="1.3.6.1.4.1.22812.11.2021.1.8.2"/>
<code nullFlavor="NI"/>
<addr>
<streetAddressLine>1234</streetAddressLine>
<streetAddressLine>1234</streetAddressLine>
<city>Blue Bell</city>
<state>Massachusetts</state>
<postalCode>02108</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1-(555)555-1515"/>
</assignedEntity>
</performer>
<performer typeCode="PRF">
<templateId root="2.16.840.1.113883.10.20.22.4.88"/>
<time nullFlavor="NI"/>
<assignedEntity>
<id nullFlavor="NI"/>
<code code="GUAR" codeSystem="2.16.840.1.113883.5.110"/>
<addr>
<streetAddressLine>1234</streetAddressLine>
<streetAddressLine>1234</streetAddressLine>
<city>Blue Bell</city>
<state>Massachusetts</state>
<postalCode>02108</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1-(555)555-1515"/>
</assignedEntity>
</performer>
<participant typeCode="COV">
<templateId root="2.16.840.1.113883.10.20.22.4.89"/>
<time nullFlavor="NI"/>
<participantRole classCode="PAT">
<id root="2.16.840.1.113883.19" extension="88800933502"/>
<code code="SELF" codeSystem="2.16.840.1.113883.5.111"/>
<addr>
<streetAddressLine>1234</streetAddressLine>
<streetAddressLine>1234</streetAddressLine>
<city>Blue Bell</city>
<state>Massachusetts</state>
<postalCode>02108</postalCode>
<country>US</country>
</addr>
<playingEntity>
<name nullFlavor="NI"/>
<sdtc:birthTime nullFlavor="NI"/>
</playingEntity>
</participantRole>
</participant>
<participant typeCode="HLD">
<templateId root="2.16.840.1.113883.10.20.22.4.90"/>
<participantRole>
<id root="1.3.6.1.4.1.22812.11.2021.1.8.2" extension="888009335"/>
</participantRole>
</participant>
<entryRelationship typeCode="REFR">
<act classCode="ACT" moodCode="DEF">
<id nullFlavor="NI"/>
<code nullFlavor="NI"/>
<text>
<reference value="#_acc82c0e-74c4-4e70-bcf5-7f68f861d97f"/>
</text>
</act>
</entryRelationship>
</act>
</entryRelationship>
</act>
</entry>
</section>
</component>
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.500" extension="2022-06-01"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<title>Care Team</title>
<text>
<table>
<caption>Care team details</caption>
<colgroup>
<col width="50%"/>
<col width="50%"/>
</colgroup>
<tbody>
<tr>
<td>
<content styleCode="xLabel">Performer Name: </content>
<content styleCode="xSecondary">Davis, Physician Albert </content>
<br/>
<content styleCode="xLabel">Role: </content>
<content styleCode="xSecondary">Primary Care Provider</content>
<br/>
<content styleCode="xLabel">Status: </content>
<content styleCode="xSecondary">active</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Duration: </content>
<content styleCode="xSecondary">24-Jul-2025 00:00 - </content>
<br/>
</td>
</tr>
<tr>
<td>
<content styleCode="xLabel">Performer Name: </content>
<content styleCode="xSecondary">Davis, ADM Nurse Tracy </content>
<br/>
<content styleCode="xLabel">Role: </content>
<content styleCode="xSecondary">Professional Nurse</content>
<br/>
<content styleCode="xLabel">Status: </content>
<content styleCode="xSecondary">active</content>
<br/>
</td>
<td>
<content styleCode="xLabel">Duration: </content>
<content styleCode="xSecondary">24-Jul-2025 00:00 - </content>
<br/>
</td>
</tr>
</tbody>
</table>
</text>
<entry>
<organizer classCode="CLUSTER" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500" extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500" extension="2022-06-01"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.17" extension="1161400271"/>
<code code="86744-0" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="completed"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20220317095500"/>
<high value="20220317235900"/>
</effectiveTime>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<templateId root="2.16.840.1.113883.10.20.22.5.6" extension="2019-10-01"/>
<time value="20250723021557"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<id root="2.16.840.1.113883.4.6" nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name nullFlavor="NI">
<family nullFlavor="NI"/>
<given nullFlavor="NI"/>
</name>
</assignedPerson>
<representedOrganization>
<id extension="89100660" root="1.3.6.1.4.1.22812.11.2021.1"/>
<id root="2.16.840.1.113883.4.2" nullFlavor="UNK"/>
<id root="2.16.840.1.113883.4.6" nullFlavor="UNK"/>
<name>Neighborhood Physicians Practi</name>
<telecom nullFlavor="UNK"/>
<addr>
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</representedOrganization>
</assignedAuthor>
</author>
<participant typeCode="PPRF">
<sdtc:functionCode code="453231000124104"
codeSystem="2.16.840.1.113883.6.96"/>
<participantRole>
<id extension="205301190" root="1.3.6.1.4.1.22812.11.2021.1.17"/>
</participantRole>
</participant>
<participant typeCode="LOC">
<participantRole>
<id extension="205301190" root="1.3.6.1.4.1.22812.11.2021.1.17"/>
<telecom nullFlavor="NI"/>
<telecom nullFlavor="NI"/>
<playingEntity classCode="PLC">
<name>
<family>Davis</family>
<given>Albert</given>
</name>
</playingEntity>
</participantRole>
</participant>
<participant typeCode="LOC">
<participantRole>
<id extension="219301190" root="1.3.6.1.4.1.22812.11.2021.1.17"/>
<telecom nullFlavor="NI"/>
<telecom nullFlavor="NI"/>
<playingEntity classCode="PLC">
<name>
<family>Davis</family>
<given>Tracy</given>
</name>
</playingEntity>
</participantRole>
</participant>
<participant typeCode="LOC">
<participantRole>
<id extension="22800210" root="1.3.6.1.4.1.22812.11.2021.1.17"/>
<addr>
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<postalCode>97006</postalCode>
<country nullFlavor="NI"/>
</addr>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<telecom value="mailto:Y...@test.com"/>
<playingEntity classCode="PLC">
<name>
<family>Holler</family>
<given>Rick</given>
</name>
</playingEntity>
</participantRole>
</participant>
<participant typeCode="LOC">
<participantRole>
<id extension="22700210" root="1.3.6.1.4.1.22812.11.2021.1.17"/>
<addr>
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<postalCode>97006</postalCode>
<country nullFlavor="NI"/>
</addr>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<telecom value="mailto:Y...@test.com"/>
<playingEntity classCode="PLC">
<name>
<family>Newman</family>
<given>Matthew</given>
</name>
</playingEntity>
</participantRole>
</participant>
<!-- <encounter>
<id root="1.3.6.1.4.1.22812.11.2021.1.3.4" extension="1000013557"/>
</encounter> -->
<component>
<act classCode="PCPR" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250730104043+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="303071001" codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="205301193" root="1.3.6.1.4.1.22812.11.0.0"/>
<id extension="2222222543" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Holler</family>
<given>Rick</given>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="38312007" codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
<component>
<act classCode="PCPR" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250730104043+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="303071001" codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="205301193" root="1.3.6.1.4.1.22812.11.0.0"/>
<id extension="2222222543" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Newman</family>
<given>Matthew</given>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="303071001" codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
<component>
<act classCode="PCPR" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250724040000+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="453231000124104"
codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="205301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<id extension="2222222541" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr use="WP">
<streetAddressLine>Tracy Davis</streetAddressLine>
<streetAddressLine>2472 Rocky Place</streetAddressLine>
<city>Beaverton</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Davis</family>
<given>Albert</given>
<suffix>Physician</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="453231000124104"
codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
<component>
<act classCode="PCPR" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250724040000+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="106292003" codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="219301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<code code="163W00000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr use="WP">
<streetAddressLine>2472</streetAddressLine>
<streetAddressLine>Rocky place</streetAddressLine>
<city>Beaverton</city>
<state>Oregon</state>
<postalCode>97006-0000</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Davis</family>
<given>Tracy</given>
<suffix>ADM Nurse</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="106292003" codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
</organizer>
</entry>
</section>
</component>
</structuredBody>
</component>
</ClinicalDocument>
Regards,
Amit Patil
On Thursday, August 14, 2025 at 10:22:00 PM UTC+5:30 Nagesh Bashyam wrote:
> Can you please attach the XML file ?
>
>
>
> *From: *edge-te...@googlegroups.com <edge-te...@googlegroups.com> on
> *To: *Edge Test Tool (ETT) <edge-te...@googlegroups.com>
> *Subject: *USCDI V3 CCDA: Invalid id root is appearing in CCDA file
>
>
>
>
>
> *CCDA File screenshot:*
> .
>
Attaching the CCDA file as below:
<?xml-stylesheet type="text/xsl"
href="https://viewer-sdo-us.csg.mdrxdev.com/stylesheets/ced/4.0/ced.xsl"
alternate="no" title="Allscripts Default" ?>
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc"
xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<realmCode code="US"/>
<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
<templateId root="2.16.840.1.113883.10.20.22.1.2" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.1.2"/>
<templateId root="2.16.840.1.113883.3.3251.1.1"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2023-05-01"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.5.5.1"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.5.5.2"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.1" extension="54845"/>
<code code="34133-9" codeSystem="2.16.840.1.113883.6.1"/>
<title>Continuity of Care Document</title>
<effectiveTime value="20250812125623-0400"/>
<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
<languageCode code="en-US"/>
<recordTarget>
<patientRole>
<id extension="111032" root="1.3.6.1.4.1.22812.11.2021.1"/>
<addr use="H">
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
<useablePeriod xsi:type="IVL_TS">
<low value="20220317"/>
</useablePeriod>
</addr>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<telecom use="MC" value="tel:+1-(555)777-1234"/>
<telecom value="mailto:Y...@test.com"/>
<patient>
<name use="L">
<family>Newman</family>
<given>Alice</given>
<given>Jones</given>
<validTime>
<low value="20220317145542+0000"/>
</validTime>
</name>
<name>
<family>Newman</family>
<given>Al</given>
<given>Jones</given>
<validTime>
<low value="20230713204806+0000"/>
<high value="20230713204806+0000"/>
</validTime>
</name>
<name>
<family qualifier="BR">Newman</family>
<given qualifier="BR">Alicia</given>
<prefix>BR</prefix>
<validTime>
<low value="20220317145543+0000"/>
</validTime>
</name>
<administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1"/>
<birthTime value="19700501"/>
<raceCode code="2106-3" codeSystem="2.16.840.1.113883.6.238"
displayName="White"/>
<sdtc:raceCode code="2108-9" codeSystem="2.16.840.1.113883.6.238"
displayName="White"/>
<ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.6.238"
displayName="Not Hispanic or Latino"/>
<!-- <sdtc:ethnicGroupCode code="2186-5"
codeSystem="2.16.840.1.113883.6.238" displayName="Not Hispanic or Latino"/>
-->
<languageCommunication>
<languageCode code="en"/>
<preferenceInd value="true"/>
</languageCommunication>
</patient>
<providerOrganization>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1"/>
<name>Neighborhood Physicians Practi</name>
<telecom nullFlavor="NI"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</providerOrganization>
</patientRole>
</recordTarget>
<author>
<templateId root="2.16.840.1.113883.3.3251.1.2"/>
<time value="20250812125623-0400"/>
<assignedAuthor>
<templateId root="2.16.840.1.113883.3.3251.1.3"/>
<id extension="205301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<id extension="2222222541" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr use="WP">
<streetAddressLine>Tracy Davis</streetAddressLine>
<streetAddressLine>2472 Rocky Place</streetAddressLine>
<city>Beaverton</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Davis</family>
<given>Albert</given>
<suffix>Physician</suffix>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<author>
<time value="20250812125623-0400"/>
<assignedAuthor>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1.3.3"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedAuthoringDevice>
<manufacturerModelName>Sunrise Clinical Manager </manufacturerModelName>
<softwareName>Sunrise Clinical Manager </softwareName>
</assignedAuthoringDevice>
<representedOrganization>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1"/>
<name>Neighborhood Physicians Practi</name>
<telecom nullFlavor="NI"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</representedOrganization>
</assignedAuthor>
</author>
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id extension="1" root="1.3.6.1.4.1.22812.11.2021.1"/>
<name>Neighborhood Physicians Practi</name>
<telecom nullFlavor="NI"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<informationRecipient>
<intendedRecipient>
<id root="1.3.6.1.4.1.22812.11.2021.1.3.1" extension="1"/>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
<receivedOrganization>
<id nullFlavor="NI"/>
<name>Neighborhood Physicians Practi</name>
<addr use="WP">
<streetAddressLine>123 First St</streetAddressLine>
<city>Raleigh</city>
<state>North Carolina</state>
<postalCode>27601</postalCode>
<country>US</country>
</addr>
</receivedOrganization>
</intendedRecipient>
</informationRecipient>
<participant typeCode="IND">
<templateId root="2.16.840.1.113883.10.20.22.5.8" extension="2023-05-01"/>
<associatedEntity classCode="GUAR">
<code nullFlavor="NA"/>
<addr>
<streetAddressLine>1357 Amber Dr</streetAddressLine>
<city>BEAVERTON</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom use="HP" value="tel:+1-(555)723-1544"/>
<associatedPerson>
<name>
<family>Newman</family>
<given>Alice</given>
<given>Jones</given>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<participant typeCode="IND">
<templateId root="2.16.840.1.113883.10.20.22.5.8" extension="2023-05-01"/>
<associatedEntity classCode="PRS">
<code code="GRPRN" codeSystem="2.16.840.1.113883.5.111"/>
<addr>
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<telecom use="HP" value="tel:+1-(555)723-1544"/>
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<country>USA</country>
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<telecom value="mailto:ab...@gmail.com"/>
<assignedPerson>
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<given>xyz</given>
<suffix>MD</suffix>
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<title>Privacy Markings</title>
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<caption styleCode="Bold"/>
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<content styleCode="xSecondary">Section Author: ProviderOne, One
PROHIBITION ON REDISCLOSURE OF CONFIDENTIAL INFORMATION
This notice accompanies a disclosure of information concerning a
client made to you with the consent of such client. This information has
been disclosed to you from records protected by federal confidentiality
rules (42 C.F.R. Part 2). The federal rules prohibit you from making any
further disclosure of this information unless further disclosure is
expressly permitted by the written consent of the person to whom it
pertains or as otherwise permitted by 42 C.F.R. Part 2. A general
authorization for the release of medical or other information is NOT
sufficient for this purpose.
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<value xsi:type="CE" code="TREAT" codeSystem="2.16.840.1.113883.5.8"/>
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<section>
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<title>Note</title>
<text>
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<tr>
<td>
<content>23-Jul-2025 9:17</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_a9c7b6c3-0499-4860-917e-a8131cac0bc3">
Procedure Notes Results [Date of Service: 23-Jul-2025 09:17, Authored:
23-Jul-2025 09:17]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the breathlessness is due to high fever and anxiety
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_fde23021-3ea1-4115-b294-6d37c224072c">
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<content>28-Mar-2025 16:34</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_104bbdec-251f-4364-a9cb-28e02165dce1">
Procedure Notes Results [Date of Service: 28-Mar-2025 16:34, Authored:
28-Mar-2025 16:34]- for Visit: 1000013557, Complete, Entered, Signed in
Full, Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the breathlessness is due to high fever and anxiety
Electronic Signatures:
test, John (MD) (Signed 28-Mar-2025 16:34)
Authored: PROCEDURE NOTE RESULTS
Last Updated: 28-Mar-2025 16:34 by test, John (MD)
</content>
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<content>17-Mar-2022 13:15</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_ff6e5607-b0b2-47e4-b061-13a835cff953">
Procedure Notes Results [Date of Service: 17-Mar-2022 13:15, Authored:
17-Mar-2022 13:15]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the
breathlessness is due to high fever and anxiety.
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_62e17da4-b7df-4ceb-b9b9-4f3165f5a9a3">
<tr>
<td>
<content>22-Jun-2015 11:55</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_736c12bd-418e-4ec6-951a-8b7194633723">
Procedure Notes Results [Date of Service: 22-Jun-2015 11:55, Authored:
18-Mar-2022 11:55]- for Visit: 1000013557, Complete, Revised, Signed in
Full, Available to Patient
PROCEDURE NOTES RESULTS:
· Procedure Results
Dr Albert Davis examined Ms Alice Newman and found that the pacemaker is
operating properly and the
breathlessness is due to high fever and anxiety
Electronic Signatures:
Last Updated: 24-Jul-2023 12:07 by test, John (MD)
</content>
</content>
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<content>23-Jul-2025 9:24</content>
</td>
</tr>
<tr>
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<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_7aa37f31-fdd5-4be3-9ab4-cb52250dc499">
Progress Note, Adult [Date of Service: 23-Jul-2025 09:24, Authored:
23-Jul-2025 09:24]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
Reason for Admission/Subjective:
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_6e1909cd-c1dc-40ab-ba68-e3699b7d5cfe">
<tr>
<td>
<content>23-Jul-2025 7:21</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
<content styleCode="xSecondary xContentWrapping">
<content ID="_5c14191a-313e-4093-a976-41e8ca1e7835">
Progress Note, Adult [Date of Service: 23-Jul-2025 07:21, Authored:
23-Jul-2025 07:21]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
Reason for Admission/Subjective:
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral.
Electronic Signatures:
</content>
</content>
</td>
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</tbody>
<tbody styleCode="xRowGroup" ID="_c4c175e3-fc23-4108-8d34-2cbf026cc760">
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<content>23-Jul-2025 7:14</content>
</td>
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<td>
<content styleCode="xIndent"> •</content>
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<content ID="_2f6cc879-5c8e-4782-a610-605acf4e2e04">
Progress Note, Adult [Date of Service: 23-Jul-2025 07:14, Authored:
23-Jul-2025 07:14]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
Reason for Admission/Subjective:
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral.
Electronic Signatures:
</content>
</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_0dd4d243-f57b-4ed1-bc22-8bb4ae4bb868">
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<content>23-Jul-2025 7:11</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
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<content ID="_09dc8064-225b-42c8-877e-56ebbb84462e">
Progress Note, Adult [Date of Service: 23-Jul-2025 07:11, Authored:
23-Jul-2025 07:11]- for Visit: 1000013557, Complete, Entered, Unsigned,
Available to Patient
Reason for Admission/Subjective:
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral.
Electronic Signatures:
</content>
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<content>28-Mar-2025 16:37</content>
</td>
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<td>
<content styleCode="xIndent"> •</content>
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<content ID="_a86f3915-8b3b-4646-8d07-23e1964778c4">
Progress Note, Adult [Date of Service: 28-Mar-2025 16:37, Authored:
28-Mar-2025 16:37]- for Visit: 1000013557, Complete, Entered, Signed in
Full, Available to Patient
Reason for Admission/Subjective:
REASON FOR ADMISSION:
· Reason for Admission Progress Note - high fever
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a nearby hospital using the provided
referral.
Electronic Signatures:
test, John (MD) (Signed 28-Mar-2025 16:37)
Authored: Reason for Admission/Subjective
Last Updated: 28-Mar-2025 16:37 by test, John (MD)
</content>
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<content>22-Jun-2015 12:26</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xIndent"> •</content>
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<content ID="_2d5295ea-548a-4434-9fca-76f5ff7de9a6">
Progress Note, Adult [Date of Service: 22-Jun-2015 12:26, Authored:
18-Mar-2022 12:26]- for Visit: 1000013557, Complete, Revised, Signed in
Full, Available to Patient
Reason for Admission/Subjective:
REASON FOR ADMISSION:
· Reason for Admission Progress note - high fever
SUBJECTIVE:
· Subjective Ms Alice Newman seems to be developing high fever and hence we
recommend her to get admitted to a
nearby hospital using the provided referral.
Electronic Signatures:
Last Updated: 24-Jul-2023 12:14 by test, John (MD)
</content>
</content>
</td>
</tr>
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</text>
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renal transplant</content>
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<content>31-Dec-2011</content>
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<content>31-Dec-2011</content>
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<content>20-Jun-2015</content>
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infection</content>
<content styleCode="xSecondary"> (004.9) (A03.9)</content>
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<content>31-Dec-2006</content>
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<content>31-Dec-2006</content>
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<content>22-Jun-2015</content>
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5:08</content>
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5:11</content>
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5:11</content>
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<td>
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<content styleCode="xSecondary">17-Mar-2022 10:55</content>
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<title>Health Concerns</title>
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<col width="20%"/>
<col width="40%"/>
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<td>
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<br/>
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<td>
<content styleCode="xLabel">Status: </content>
<content>Active</content>
<br/>
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<br/>
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<td>
<content styleCode="xLabel">Status: </content>
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<br/>
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<br/>
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<td>
<content styleCode="xLabel">Status: </content>
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<br/>
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<br/>
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<content styleCode="xLabel">Status: </content>
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<br/>
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<content styleCode="Italics">Related To: </content>
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<content styleCode="xSecondary">22-Jun-2015</content>
<br/>
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<content styleCode="xSecondary">12-Aug-2025 03:38</content>
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<content styleCode="xSecondary">12-Aug-2025
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<content>22-Jun-2015</content>
<br/>
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<br/>
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<content styleCode="xSecondary">22-Jun-2015</content>
<br/>
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<content styleCode="xSecondary">22-Jun-2015</content>
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<br/>
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<td>
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<content styleCode="xSecondary">31-Dec-2006</content>
<br/>
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<td/>
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<component>
<section>
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<templateId root="2.16.840.1.113883.10.20.22.2.10"/>
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<title>Plan of Treatment</title>
<text>
<table>
<caption>Goals</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup" ID="_314fe093-b2e9-460c-9f0d-0ae367472c2c">
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<td>
<content ID="_062d2302-b227-423a-ba5e-4db9970e0e36">Planning Goal: Address
anemia</content>
</td>
<td/>
<td/>
</tr>
</tbody>
</table>
<table>
<caption>Planned Immunizations</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr ID="_4acd0d92-eb9a-46e5-a829-fae26cc87de7">
<td>
<content styleCode="xContentWrapping">
<content ID="_e8341bcf-7de6-475f-9c38-78ff536b5043">Anthrax</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_9b5b6951-2102-4130-972f-fbcde8f7c4b9">
<td>
<content styleCode="xContentWrapping">
<content ID="_676af552-7e11-41bf-adab-3f09d08bf7da">Bacillus
Calmette-Guerin (BCG)</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
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<td>
<content styleCode="xContentWrapping">
<content ID="_3761e83e-f3f3-4a32-a1b0-ad0eadb9d859">Hepatitis A</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
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<td>
<content styleCode="xContentWrapping">
<content ID="_9def68de-b91f-4e17-82ce-96936b179497">Human Papilloma Virus
(HPV)</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_d48bcc2f-f3b3-4ee1-b980-355d29a2b66e">
<td>
<content styleCode="xContentWrapping">
<content ID="_f66ad55d-f424-44f0-9844-91841ea5816e">Influenza</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_f9e85003-32cd-4741-b284-682c1ddd3227">
<td>
<content styleCode="xContentWrapping">
<content ID="_892ad540-a220-4a6c-b442-de2c64ebe691">Tetanus</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_f0dd1f14-832f-4cf1-826c-3f6e87650fbd">
<td>
<content styleCode="xContentWrapping">
<content ID="_2a07172d-0af5-430f-b192-7ed5581205f4">Tdap</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr ID="_a54e28f9-8ca5-4f2f-b344-b5a984aca95e">
<td>
<content styleCode="xContentWrapping">
<content ID="_bd6d4435-1b75-4ff7-bbb1-8e3ff03e88dd">Varicella</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
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<td>
<content styleCode="xContentWrapping">
<content ID="_95d6541f-82ba-46e4-8f25-f527c2acda60">Coronavirus
(COVID-19)</content>
<br/>
</content>
</td>
<td>
<content styleCode="xLabel">Scheduled for Administration</content>
<br/>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
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<table>
<caption>Planned Procedures</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
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<td>
<content styleCode="xContentWrapping"
ID="_cf2fc628-871a-4129-8920-44d0b47859f0">Order_Procedure_SDOH</content>
</td>
<td/>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_24dc0334-d029-4fe4-adbc-ffb6ab8ea0eb">
<tr>
<td>
<content styleCode="xContentWrapping"
ID="_d4125b73-1841-40d6-b75f-e56cd1fc9c8a">Assistance with application for
food pantry program</content>
</td>
<td/>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_09ad177e-8962-41fc-8c52-75e7c1da4ede">
<tr>
<td>
<content styleCode="xContentWrapping"
ID="_24063878-7769-4f6a-ac48-d4f58dcaa8f5">Future Procedure List:
EKG</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">23-Jun-2015</content>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup" ID="_225026d0-4963-49f8-b56e-05778b96e3d5">
<tr>
<td>
<content styleCode="xContentWrapping"
ID="_86d0394e-af91-4556-8a39-7fc632520ab3">Future Procedure Text:
EKG</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">23-Jun-2015</content>
</td>
<td>
<content styleCode="xSecondary">Request</content>
<br/>
</td>
</tr>
</tbody>
</table>
<table>
<caption>Planned Encounters</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
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<td>
<content styleCode="xContentWrapping">
<content ID="_3e7f66a3-4b2b-41d0-b5b4-f34a7cf45d5d">Future Encounters Text:
i. Get an EKG done on 6/23/2015.
ii. Get a Chest X-ray done on 6/23/2015 showing the Lower Respiratory Tract
Structure.
iii. Take Clindamycin 300mg three times a day as needed if pain does not
subside.
iv. Schedule follow on visit with Neighborhood Physicians Practice on
7/1/2015. </content>
<br/>
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</content>
</td>
<td/>
<td>
<content>Intent </content>
<br/>
</td>
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<td>
<content styleCode="xContentWrapping">
<content ID="_bb21b344-de7f-4177-a666-392fd9e1cc8f">Future Encounters Text:
Get an EKG done on 6/23/2015.
Get a Chest X-ray done on 6/23/2015 showing the Lower Respiratory Tract
Structure.
Take Clindamycin 300mg three times a day as needed if pain does not subside/
Schedule follow on visit with Neighborhood Physicians Practice on
7/1/2015.
</content>
<br/>
<content styleCode="xSecondary"/>
</content>
</td>
<td/>
<td>
<content>Intent </content>
<br/>
</td>
</tr>
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</table>
<table>
<caption>Planned Observations</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr ID="_e26e54d7-1744-449a-8ae0-b811461d8702">
<td>
<content ID="_94ced7fe-006c-4f0c-8bbc-77161a13b10d">Urinalysis macro
(dipstick) panel</content>
<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">31-Aug-2025
0:00</content>
<br/>
</td>
<td>
<content>Request</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
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<br/>
</td>
<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">31-Jul-2025
0:00</content>
<br/>
</td>
<td>
<content>Request</content>
</td>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
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<content ID="_e70163d8-a992-41db-98af-4dba2b6b5fbd">Urinalysis macro
(dipstick) panel</content>
<br/>
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<td>
<content styleCode="xLabel xSecondary">Start: </content>
<content styleCode="xSecondary">25-Aug-2025
0:00</content>
<br/>
</td>
<td>
<content>Request</content>
</td>
</tr>
</tbody>
</table>
<table>
<caption>Instructions</caption>
<colgroup>
<col width="40%"/>
<col width="20%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
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<td>
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<content>Planning Goal Instructions Text: a. Get rid of intermittent fever
that is occurring every few weeks.</content>
<br/>
</content>
</td>
<td/>
<td>
<content styleCode="xLabel">Instruction Type: </content>
<content
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<br/>
</td>
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<time value="20250807071657+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
<id root="1.3.6.1.4.1.22812.11.2021.1.3.4" extension="1000013557"/>
</encounter>
</entryRelationship>
</observation>
</entryRelationship>
<entryRelationship typeCode="SUBJ">
<encounter classCode="ENC" moodCode="EVN">
<id root="1.3.6.1.4.1.22812.11.2021.1.3.4" extension="1000013557"/>
</encounter>
</entryRelationship>
</procedure>
</entry>
<entry>
<procedure classCode="PROC" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2022-06-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.7" extension="INT"/>
<code code="102594003" codeSystem="2.16.840.1.113883.6.5">
<originalText>
<reference value="#_24063878-7769-4f6a-ac48-d4f58dcaa8f5"/>
</originalText>
</code>
<text>
<reference value="#_09ad177e-8962-41fc-8c52-75e7c1da4ede"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20150623040000+0000"/>
</effectiveTime>
</procedure>
</entry>
<entry>
<procedure classCode="PROC" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2022-06-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.41"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.7" extension="INT"/>
<code nullFlavor="NI">
<originalText>
<reference value="#_86d0394e-af91-4556-8a39-7fc632520ab3"/>
</originalText>
</code>
<text>
<reference value="#_225026d0-4963-49f8-b56e-05778b96e3d5"/>
</text>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20150623040000+0000"/>
</effectiveTime>
</procedure>
</entry>
<entry>
<act classCode="ACT" moodCode="INT">
<templateId root="2.16.840.1.113883.10.20.22.4.20" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.20"/>
<code code="Self-carePatientEducation" codeSystem="2.16.840.1.113883.6.96">
<originalText>
<reference value="#_d61694c9-2ca6-47d0-a8bb-0299d051117b"/>
</originalText>
</code>
<text>
<reference value="#_5535534c-fe97-4da3-9c2c-5a38d7219aae"/>
</text>
<statusCode code="completed"/>
</act>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32047"/>
<text>
<reference value="#_4acd0d92-eb9a-46e5-a829-fae26cc87de7"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
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<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="24" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_e8341bcf-7de6-475f-9c38-78ff536b5043"/>
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</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Emergent BioDefense Operations Lansing</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
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<time value="20220317170318+0000"/>
<assignedAuthor>
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<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
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</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
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<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32045"/>
<text>
<reference value="#_9b5b6951-2102-4130-972f-fbcde8f7c4b9"/>
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<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
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<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
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<originalText>
<reference value="#_676af552-7e11-41bf-adab-3f09d08bf7da"/>
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</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Sanofi Pasteur</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
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<time value="20220317170318+0000"/>
<assignedAuthor>
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<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.120"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32042"/>
<text>
<reference value="#_b0376ec3-0bba-425b-a320-9b7634533fbb"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="83" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_3761e83e-f3f3-4a32-a1b0-ad0eadb9d859"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>GlaxoSmithKline</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20220317170318+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.120"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32041"/>
<text>
<reference value="#_bd316335-e045-45c0-a2e5-4ba90b793e44"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="137" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_9def68de-b91f-4e17-82ce-96936b179497"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20220317170318+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.120"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="45029"/>
<text>
<reference value="#_d48bcc2f-f3b3-4ee1-b980-355d29a2b66e"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="141" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_f66ad55d-f424-44f0-9844-91841ea5816e"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>bioCSL</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20250725071341+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.120"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32051"/>
<text>
<reference value="#_f9e85003-32cd-4741-b284-682c1ddd3227"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="112" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_892ad540-a220-4a6c-b442-de2c64ebe691"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20220318191258+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.120"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32043"/>
<text>
<reference value="#_f0dd1f14-832f-4cf1-826c-3f6e87650fbd"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="115" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_2a07172d-0af5-430f-b192-7ed5581205f4"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Sanofi Pasteur</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20220317170318+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.120"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32044"/>
<text>
<reference value="#_a54e28f9-8ca5-4f2f-b344-b5a984aca95e"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="21" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_bd6d4435-1b75-4ff7-bbb1-8e3ff03e88dd"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Merck &Co., Inc.</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20220317170318+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="RQO">
<templateId root="2.16.840.1.113883.10.20.22.4.120"/>
<id root="1.3.6.1.4.1.22812.11.2021.1.4.13" extension="32048"/>
<text>
<reference value="#_c4f3b6a8-9d20-44a1-ab2e-24069cea8c38"/>
</text>
<statusCode code="active"/>
<effectiveTime nullFlavor="NI"/>
<consumable>
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial>
<code code="207" codeSystem="2.16.840.1.113883.12.292">
<originalText>
<reference value="#_95d6541f-82ba-46e4-8f25-f527c2acda60"/>
</originalText>
</code>
<lotNumberText nullFlavor="NI"/>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Moderna US, Inc.</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20220317170318+0000"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</substanceAdministration>
</entry>
<entry>
<observation classCode="OBS" moodCode="GOL">
<templateId root="2.16.840.1.113883.10.20.22.4.121" extension="2022-06-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.121"/>
<id nullFlavor="NI"/>
<code nullFlavor="UNK">
<originalText>
<reference value="#_062d2302-b227-423a-ba5e-4db9970e0e36"/>
</originalText>
</code>
<text>
<reference value="#_314fe093-b2e9-460c-9f0d-0ae367472c2c"/>
</text>
<statusCode code="active"/>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time nullFlavor="NI"/>
<assignedAuthor>
<id nullFlavor="UNK"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
<state nullFlavor="UNK"/>
<postalCode nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="UNK"/>
</assignedAuthor>
</author>
</observation>
</entry>
</section>
</component>
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.3" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.2.3"/>
<templateId root="2.16.840.1.113883.10.20.22.2.3.1" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.2.3.1"/>
<code code="30954-2" codeSystem="2.16.840.1.113883.6.1"/>
<title>Results</title>
<text>
<table>
<colgroup>
<col width="20%"/>
<col width="40%"/>
<col width="40%"/>
</colgroup>
<tbody styleCode="xRowGroup">
<tr>
<td>
<content styleCode="xSecondary"
ID="_98e020e5-51c6-4e8b-ac2f-daf2138a8dda">Urinalysis macro (dipstick)
panel</content>
</td>
<td>
<content styleCode="xLabel">Ordered On: </content>
<content>12-Aug-2025
6:58</content>
</td>
<td/>
</tr>
<tr ID="_6e3d1e62-6de0-454c-b54e-2ed98e9fedcb">
<td>
<content styleCode="xSecondary xContentWrapping">12-Aug-2025 7:01</content>
</td>
<td>
<content styleCode="xSecondary"
ID="_c501df0c-433c-47c4-b1f9-5e4fe3ba4dfc">Urine Specific Gravity</content>
<content styleCode="xSecondary"> 1.015</content>
<content styleCode="xSecondary"> {Unit(s)}</content>
</td>
<td>
<content ID="_ef2fbcf2-a7fc-456d-aa42-0e3053a48382">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 1.005 - 1.030 Unit(s)</content>
<br/>
</content>
</td>
</tr>
<tr>
<td>
<content styleCode="xLabel xSecondary">Specimen Type: </content>
<content styleCode="xSecondary xContentWrapping">Urinary specimen
(specimen)</content>
<br/>
</td>
<td/>
<td/>
</tr>
</tbody>
<tbody styleCode="xRowGroup">
<tr>
<td>
<content styleCode="xSecondary"
ID="_59802fe7-923d-4141-a4f8-3f24d0746599">Urine Dipstick, POCT</content>
</td>
<td>
<content styleCode="xLabel">Ordered On: </content>
<content>21-Mar-2022
13:56</content>
</td>
<td/>
</tr>
<tr ID="_991912f0-35c9-4c98-bb2a-89107629e8cb">
<td>
<content styleCode="xSecondary xContentWrapping">21-Mar-2022 13:56</content>
</td>
<td>
<content styleCode="xSecondary"
ID="_dd375862-d97d-48fe-b117-91f6e64892b0">Urine Glucose</content>
<content styleCode="xSecondary"> 50 mg/dL</content>
</td>
<td>
<content ID="_0f82695e-3acb-457e-adbc-943c2fb4936c">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Neg</content>
<br/>
</content>
</td>
</tr>
<tr ID="_c7e894bf-71ea-498f-a4a7-231122bc26eb">
<td/>
<td>
<content styleCode="xSecondary"
ID="_e3dd466b-8d14-44f6-8a31-21a23da7cd83">Ketones</content>
<content styleCode="xSecondary"> Negative</content>
</td>
<td>
<content ID="_720c7c9a-7bff-4ab2-b125-26f1eb71cf90">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Negative</content>
<br/>
</content>
</td>
</tr>
<tr ID="_4889d501-9e1e-4938-a4cf-b4a6dd5d7a7a">
<td/>
<td>
<content styleCode="xSecondary"
ID="_f922259e-b01c-4be7-8d8b-9f7bf5394a42">Protein</content>
<content styleCode="xSecondary"> 100 mg/dL</content>
</td>
<td/>
</tr>
<tr ID="_48309965-3a20-4450-b550-186cddf19913">
<td/>
<td>
<content styleCode="xSecondary"
ID="_54498502-58c7-4526-a70d-25a17a19c626">Urine Specific Gravity</content>
<content styleCode="xSecondary"> 1.015</content>
</td>
<td>
<content ID="_b49c40eb-368d-4b02-93dd-b90860999ebd">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 1.005 - 1.030</content>
<br/>
</content>
</td>
</tr>
<tr ID="_4d2bb956-aede-42a0-8f8e-e14310449a49">
<td/>
<td>
<content styleCode="xSecondary"
ID="_836edce4-a925-4030-92a6-cb32c60c74e7">Urine pH</content>
<content styleCode="xSecondary"> 5.0</content>
</td>
<td>
<content ID="_92d33752-942d-448a-9617-8fa841ea48a6">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 5.0 - 8.0</content>
<br/>
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<content styleCode="xSecondary"> Yellow</content>
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<td>
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<content styleCode="xSecondary"> Yellow</content>
<br/>
</content>
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<tr ID="_f113fc20-16eb-4435-b6c0-a438e9740bf4">
<td/>
<td>
<content styleCode="xSecondary"
ID="_7c36e5f1-ccba-4542-a6fb-ef92dc718faa">Urine Appearance</content>
<content styleCode="xSecondary"> Clear</content>
</td>
<td>
<content ID="_778e3210-0952-431f-8c15-06c139f9301c">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Clear</content>
<br/>
</content>
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<tr>
<td>
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<content styleCode="xSecondary xContentWrapping">Urinary specimen
(specimen)</content>
<br/>
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<td/>
<td/>
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panel</content>
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<td>
<content styleCode="xLabel">Ordered On: </content>
<content>17-Mar-2022
13:38</content>
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<td>
<content styleCode="xSecondary xContentWrapping">17-Mar-2022 16:02</content>
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<td>
<content styleCode="xSecondary"
ID="_0a0f4cc4-87e0-4888-b79c-0296c75f339d">Urine Appearance</content>
<content styleCode="xSecondary"> Clear</content>
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<td>
<content ID="_e82d5d0e-e75b-4a18-b8ff-d940d664a3ac">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Clear</content>
<br/>
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<td/>
<td>
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<td>
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<content styleCode="xSecondary"> YELLOW</content>
<br/>
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<td>
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<content styleCode="xSecondary"> 50</content>
<content styleCode="xSecondary"> mg/dL</content>
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<td>
<content ID="_7b4aaa64-679b-45dd-95af-49b9c6582a97">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Neg mg/dL</content>
<br/>
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<tr ID="_e7aa3af6-a797-41ef-9a01-2407d003ece7">
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<td>
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<content styleCode="xSecondary"> Negative</content>
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<td>
<content ID="_2c9499e6-c818-4431-b75e-1818a462109a">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> Negative</content>
<br/>
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<td/>
<td>
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<content styleCode="xSecondary"> 1.015</content>
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<td>
<content ID="_e8f7f3ed-25fe-4f13-83f8-4129a3da9c71">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 1.005 - 1.030</content>
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<td>
<content styleCode="xSecondary"
ID="_7b4664e8-d850-49ba-a3ef-83a2cf17af03">Urine pH</content>
<content styleCode="xSecondary"> 5.0</content>
<content styleCode="xSecondary"> [pH]</content>
</td>
<td>
<content ID="_5c9b91c1-6e77-4236-8e09-1b6f39f956cf">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> 5.0 - 8.0 [pH]</content>
<br/>
</content>
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<tr ID="_ff7a88da-e971-4887-b888-0acf44cf3549">
<td/>
<td>
<content styleCode="xSecondary"
ID="_86374cd2-bd14-46b8-8985-b83f69d8f088">Protein</content>
<content styleCode="xSecondary"> 100</content>
<content styleCode="xSecondary"> mg/dL</content>
</td>
<td>
<content ID="_a1a3f163-6605-43d4-a993-3989a6cf51f8">
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"> negative mg/dL</content>
<br/>
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<tr>
<td>
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<content styleCode="xSecondary xContentWrapping">Urinary specimen
(specimen)</content>
<br/>
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<title>Vital Signs</title>
<text>
<table styleCode="xBorderBottom">
<colgroup>
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<col width="20%"/>
<col width="40%"/>
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<tbody styleCode="xRowGroup">
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<td>
<content>11-Mar-2025
12:30</content>
</td>
<td/>
<td/>
</tr>
<tr ID="_0cad1cf9-81d5-4827-93ea-61444e916da4">
<td/>
<td>
<content>
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ID="_c720c7b6-78ab-4c49-bb78-4c6003c3512d">Heart Rate </content>
<content styleCode="xSecondary">80</content>
<content styleCode="xSecondary"> /min </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_6db72413-d721-4e61-b75f-6b979d2a87c2">High</content>
<content styleCode="xSecondary">)</content>
</content>
</td>
<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_e65f1d5f-d5b1-491d-8058-a77f4d6aabf4">0 - 9999</content>
</td>
</tr>
<tr ID="_2b07ff4a-ec1b-4a97-af15-ef52ebc9dd06">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_f4dc2fec-0c5a-4775-85bc-286caca8a82c">O2 SAT </content>
<content styleCode="xSecondary">95</content>
<content styleCode="xSecondary"> % </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_716282e4-c605-47f3-b752-91fa0d8eecb9">Normal</content>
<content styleCode="xSecondary">)</content>
</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_d300f985-53ed-4da7-b4f7-b6413dff12f5">0 - 100</content>
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</tr>
<tr ID="_8b573280-9af7-4696-822a-4d92050d9807">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_650bed64-7059-46a4-bb4d-bddf972dbaf1">BP Systolic </content>
<content styleCode="xSecondary">145</content>
<content styleCode="xSecondary"> mm[Hg] </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_b0178184-c99b-4be1-877f-eb0fd1c6cecf">High</content>
<content styleCode="xSecondary">)</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_bf073fbc-e075-4015-af0e-ac8b16865b4c">0 - 200</content>
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<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_5fa47d6c-3175-4f7e-8333-2e9e145c4bbd">BP Diastolic </content>
<content styleCode="xSecondary">88</content>
<content styleCode="xSecondary"> mm[Hg] </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_10720ea2-6b89-4464-87a0-9a07d846c749">High</content>
<content styleCode="xSecondary">)</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_9533af43-0d29-4dbb-8ff7-fc4fd68c3e8f">0 - 150</content>
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<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_09c1ac4c-d806-4f48-9020-4fce8d637b61">Temperature </content>
<content styleCode="xSecondary">38</content>
<content styleCode="xSecondary"> c </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_d85be691-7ed2-48e8-a803-7f22196e3baa">Normal</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_6bda3e7a-4f29-47f3-b5da-49bd49e53540">0 - 200</content>
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<td/>
<td>
<content>
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ID="_5ca693a2-c7fd-4b65-9c2d-389084faca2e">Height </content>
<content styleCode="xSecondary">177</content>
<content styleCode="xSecondary"> cm </content>
<content>(</content>
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ID="_95b5ac31-5a90-460f-ac90-7e3289732864">High</content>
<content styleCode="xSecondary">)</content>
</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_dad5623a-f0ea-41c2-9c88-f1b984b02d2d">0 - 200</content>
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<td/>
<td>
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<content styleCode="xSecondary"
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<content styleCode="xSecondary">88</content>
<content styleCode="xSecondary"> kg </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_e6eafa1f-547a-49dd-abe5-0dc7b97928af">Critical High</content>
<content styleCode="xSecondary">)</content>
</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_303a3348-399d-452a-8652-b86bd359ae99">0 - 100</content>
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<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_02b40d1e-5b83-47e4-bf82-9db70b857d3a">BMI </content>
<content styleCode="xSecondary">28</content>
<content styleCode="xSecondary"> kg/m2 </content>
</content>
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<td/>
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<tr ID="_5b81d27d-b36d-4800-bf25-a02b013d54dd">
<td/>
<td>
<content>
<content styleCode="xSecondary"
ID="_42c24e1e-001c-4fc3-957f-261ac645cc0a">BSA </content>
<content styleCode="xSecondary">2.05</content>
<content styleCode="xSecondary"> m2 </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_b2b902a3-d30a-40a3-9036-8c4e8c255b72">High</content>
<content styleCode="xSecondary">)</content>
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<td>
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<content styleCode="xSecondary"
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<td/>
<td>
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ID="_289fab24-3ad9-42c3-a28f-74ef3b559a0d">Respiratory rate </content>
<content styleCode="xSecondary">18</content>
<content styleCode="xSecondary"> /min </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_45f88baa-bd40-420f-89c4-5b7edd7b292d">Low</content>
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<td>
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<content styleCode="xSecondary"
ID="_13e7ae2c-3b96-4327-a1d9-38e79a7e8e2b">0 - 150</content>
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<td/>
<td>
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<content styleCode="xSecondary"
ID="_69157a80-7ad4-4af3-9d21-19e3c8d609d9">Inhaled oxygen concentration
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<content styleCode="xSecondary">36</content>
<content styleCode="xSecondary"> % </content>
<content>(</content>
<content styleCode="xSecondary"
ID="_a375b26a-4f2c-49a1-ae14-ebf0792a4e70">Critical High</content>
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</content>
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<td>
<content styleCode="xLabel xSecondary">Range: </content>
<content styleCode="xSecondary"
ID="_66c9db32-a0f0-4997-93ff-af354e6baa53">0 - 50</content>
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extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250730104043+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="303071001" codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="205301193" root="1.3.6.1.4.1.22812.11.0.0"/>
<id extension="2222222543" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Holler</family>
<given>Rick</given>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="38312007" codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
<component>
<act classCode="PCPR" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250730104043+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="303071001" codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="205301193" root="1.3.6.1.4.1.22812.11.0.0"/>
<id extension="2222222543" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine nullFlavor="UNK"/>
<city nullFlavor="UNK"/>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Newman</family>
<given>Matthew</given>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="303071001" codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
<component>
<act classCode="PCPR" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250724040000+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="453231000124104"
codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="205301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<id extension="2222222541" root="2.16.840.1.113883.4.6"/>
<code code="200000000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr use="WP">
<streetAddressLine>Tracy Davis</streetAddressLine>
<streetAddressLine>2472 Rocky Place</streetAddressLine>
<city>Beaverton</city>
<state>Oregon</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Davis</family>
<given>Albert</given>
<suffix>Physician</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="453231000124104"
codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
<component>
<act classCode="PCPR" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2019-07-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.500.1"
extension="2022-06-01"/>
<id nullFlavor="NI"/>
<code code="85847-2" codeSystem="2.16.840.1.113883.6.1"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20250724040000+0000"/>
</effectiveTime>
<performer typeCode="PRF">
<sdtc:functionCode code="106292003" codeSystem="2.16.840.1.113883.6.96"/>
<assignedEntity>
<id extension="219301190" root="1.3.6.1.4.1.22812.11.2021.1"/>
<code code="163W00000X" codeSystem="2.16.840.1.113883.6.101"/>
<addr use="WP">
<streetAddressLine>2472</streetAddressLine>
<streetAddressLine>Rocky place</streetAddressLine>
<city>Beaverton</city>
<state>Oregon</state>
<postalCode>97006-0000</postalCode>
<country>US</country>
</addr>
<telecom nullFlavor="NI"/>
<assignedPerson>
<name>
<family>Davis</family>
<given>Tracy</given>
<suffix>ADM Nurse</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="IND">
<sdtc:functionCode code="106292003" codeSystem="2.16.840.1.113883.6.96"/>
<participantRole/>
</participant>
</act>
</component>
</organizer>
</entry>
</section>
</component>
</structuredBody>
</component>
</ClinicalDocument>
Regards,
Amit Patil
On Thursday, August 14, 2025 at 10:22:00 PM UTC+5:30 Nagesh Bashyam wrote:
> Can you please attach the XML file ?
>
>
>
> behalf of Amit Patil <amitpa...@gmail.com>
> *Date: *Thursday, August 14, 2025 at 12:32 PM
> *To: *Edge Test Tool (ETT) <edge-te...@googlegroups.com>
> *Subject: *USCDI V3 CCDA: Invalid id root is appearing in CCDA file
> resulting in errors in HealthIT CCDA Validator
>
> Hello Community,
>
>
>
> I’m currently working on validating the
> 170.315_b1_toc_amb_svap_uscdiv3_sample1_v1 CCDA document using the CCDAV3
> validator, and I'm encountering an issue related to invalid root id for
> Payers>> Guarantor>> entryRelationship node in CCDA file.
>
>
>
> *Health IT Validation error:*
>
> Hello Community,
>
>
>
> I’m currently working on validating the
> 170.315_b1_toc_amb_svap_uscdiv3_sample1_v1 CCDA document using the CCDAV3
> validator, and I'm encountering an issue related to invalid root id for
> Payers>> Guarantor>> entryRelationship node in CCDA file.
>
>
>
>
>
>
>
>
> *CCDA File screenshot:*
>
>
>
>
>
> It seems extension value is getting inserted to id root and if we try to
> provide valid ID root with the extension (For ex. <id
> root="2.16.840.1.113883.19.5" extension="765600201"/>), CCDA Validator
> throws Null Pointer exception. Please see below screenshot:
>
>
>
>
>
>
>
> *Please advise on how to overcome this issue. *
>
>
>
>
> It seems extension value is getting inserted to id root and if we try to
> provide valid ID root with the extension (For ex. <id
> root="2.16.840.1.113883.19.5" extension="765600201"/>), CCDA Validator
> throws Null Pointer exception. Please see below screenshot:
>
>
>
>
>
>
>
>
>
>
>
>
> Best Regards,
>
> Amit Patil
>
> --
> You received this message because you are subscribed to the Google Groups
> "Edge Test Tool (ETT)" group.
> To unsubscribe from this group and stop receiving emails from it, send an
> email to edge-test-too...@googlegroups.com.
> To view this discussion visit
> https://groups.google.com/d/msgid/edge-test-tool/66b8e26c-a623-483b-8077-22968aef262bn%40googlegroups.com
> <https://groups.google.com/d/msgid/edge-test-tool/66b8e26c-a623-483b-8077-22968aef262bn%40googlegroups.com?utm_medium=email&utm_source=footer>
>
>
>
>
> Best Regards,
>
> Amit Patil
>
> --
> You received this message because you are subscribed to the Google Groups
> "Edge Test Tool (ETT)" group.
> To unsubscribe from this group and stop receiving emails from it, send an
> email to edge-test-too...@googlegroups.com.
> To view this discussion visit
> https://groups.google.com/d/msgid/edge-test-tool/66b8e26c-a623-483b-8077-22968aef262bn%40googlegroups.com
> .
>
Amit Patil
Aug 19, 2025, 12:44:46 PMAug 19
to Edge Test Tool (ETT)
Hi Community/Nagesh,
Any thoughts on this issue?
Regards,
Amit Patil
Message has been deleted
Amit Patil
Aug 20, 2025, 8:42:05 AMAug 20
to Edge Test Tool (ETT), Nagesh Bashyam
Hello Nagesh,
I have attached the CCDA xml file for this discussion. Can you please help
us on this blocker issue?
Regards,
Amit Patil
> You received this message because you are subscribed to a topic in the
> https://groups.google.com/d/topic/edge-test-tool/BA57llQHzes/unsubscribe.
> To unsubscribe from this group and all its topics, send an email to
> https://groups.google.com/d/msgid/edge-test-tool/cf55d937-cc38-42d9-83fa-eb476abbe68bn%40googlegroups.com
> <https://groups.google.com/d/msgid/edge-test-tool/cf55d937-cc38-42d9-83fa-eb476abbe68bn%40googlegroups.com?utm_medium=email&utm_source=footer>
> .
>
I have attached the CCDA xml file for this discussion. Can you please help
us on this blocker issue?
Regards,
Amit Patil
> Google Groups "Edge Test Tool (ETT)" group.
> To unsubscribe from this topic, visit
> https://groups.google.com/d/topic/edge-test-tool/BA57llQHzes/unsubscribe.
> To unsubscribe from this group and all its topics, send an email to
> https://groups.google.com/d/msgid/edge-test-tool/cf55d937-cc38-42d9-83fa-eb476abbe68bn%40googlegroups.com
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> .
>
Nagesh Bashyam
Aug 20, 2025, 9:00:22 AMAug 20
to Amit Patil, Edge Test Tool (ETT)
We are looking into it.
From: edge-te...@googlegroups.com <edge-te...@googlegroups.com> on behalf of Amit Patil <amitpa...@gmail.com>
Date: Thursday, August 14, 2025 at 12:32
PM
To: Edge Test Tool (ETT) <edge-te...@googlegroups.com>
Subject: USCDI V3 CCDA: Invalid id root is appearing in CCDA file resulting in errors in HealthIT CCDA Validator
Hello Community,
I’m currently working on validating the 170.315_b1_toc_amb_svap_uscdiv3_sample1_v1 CCDA document using the CCDAV3 validator, and I'm encountering an issue related to invalid root id for Payers>> Guarantor>> entryRelationship node in CCDA file.
Health IT Validation error:
CCDA File screenshot:
It seems extension value is getting inserted to id root and if we try to provide valid ID root with the extension (For ex. <id root="2.16.840.1.113883.19.5" extension="765600201"/>), CCDA Validator throws Null Pointer exception. Please see below screenshot:
Please advise on how to overcome this issue.
Best Regards,
Amit Patil
--
You received this message because you are subscribed to the Google Groups "Edge Test Tool (ETT)" group.
To unsubscribe from this group and stop receiving emails from it, send an email to edge-test-too...@googlegroups.com.
To view this discussion visit https://groups.google.com/d/msgid/edge-test-tool/66b8e26c-a623-483b-8077-22968aef262bn%40googlegroups.com.
--
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