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| # | Location | File | Last Modified |
|---|---|---|---|
| 1 | C:\working_scrub\Unredacted\VAP Code Base\VAP_Bld2_Source_Code_CIF_2017-02-14\nvap-web\src\main\resources\gov\va\nvap\mock\report\sampleExportSQA\20170112\KAISER PERMANENTE | 374430_C32_20161201.xml | Thu Jan 12 19:48:34 2017 UTC |
| 2 | eHX-CIF.zip\eHX-CIF\VAP Code Base\VAP_Bld2_Source_Code_CIF_2017-02-14\nvap-web\src\main\resources\gov\va\nvap\mock\report\sampleExportSQA\20170112\KAISER PERMANENTE | 374430_C32_20161201.xml | Mon Apr 3 14:15:18 2017 UTC |
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| Character case | Differences in character case are significant |
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| 1 | <?xml | |
| 2 | version="1 .0" | |
| 3 | encoding=" UTF-8" | |
| 4 | ?> | |
| 5 | <ClinicalD ocument | |
| 6 | xmlns="urn :hl7-org:v 3" | |
| 7 | > | |
| 8 | <realmCode | |
| 9 | code="US" | |
| 10 | /> | |
| 11 | <typeId | |
| 12 | extension= "POCD_HD00 0040" | |
| 13 | root="2.16 .840.1.113 883.1.3" | |
| 14 | /> | |
| 15 | <templateI d | |
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| 17 | /> | |
| 18 | <templateI d | |
| 19 | root="2.16 .840.1.113 883.10.20. 22.1.1" | |
| 20 | /> | |
| 21 | <templateI d | |
| 22 | root="2.16 .840.1.113 883.10.20. 22.1.1" | |
| 23 | extension= "2015-08-0 1" | |
| 24 | /> | |
| 25 | <templateI d | |
| 26 | root="2.16 .840.1.113 883.10.20. 22.1.2" | |
| 27 | /> | |
| 28 | <templateI d | |
| 29 | root="2.16 .840.1.113 883.10.20. 22.1.2" | |
| 30 | extension= "2015-08-0 1" | |
| 31 | /> | |
| 32 | <id | |
| 33 | assigningA uthorityNa me="EPC" | |
| 34 | root="1.2. 840.114350 .1.13.112. 3.7.8.6888 83.7121987 5" | |
| 35 | /> | |
| 36 | <code | |
| 37 | code="3413 3-9" | |
| 38 | codeSystem ="2.16.840 .1.113883. 6.1" | |
| 39 | codeSystem Name="LOIN C" | |
| 40 | displayNam e="Summari zation of Episode No te" | |
| 41 | /> | |
| 42 | <title> | |
| 43 | Clinical S ummary | |
| 44 | </title> | |
| 45 | <effective Time | |
| 46 | value="201 6120114550 3-0700" | |
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| 54 | code="en-U S" | |
| 55 | /> | |
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| 57 | assigningA uthorityNa me="EPC" | |
| 58 | extension= "cb82933e- 9c60-11e6- 9e7c-dd02e 4a69461" | |
| 59 | root="1.2. 840.114350 .1.13.112. 3.7.1.1" | |
| 60 | /> | |
| 61 | <versionNu mber | |
| 62 | value="27" | |
| 63 | /> | |
| 64 | <recordTar get> | |
| 65 | <patientRo le> | |
| 66 | <id | |
| 67 | root="1.2. 840.114350 .1.13.112. 3.7.3.6888 84.100" | |
| 68 | extension= "KCT559782 6" | |
| 69 | /> | |
| 70 | <addr | |
| 71 | use="HP" | |
| 72 | > | |
| 73 | <streetAdd ressLine> | |
| 74 | 1100 Test Street | |
| 75 | </streetAd dressLine> | |
| 76 | <city> | |
| 77 | HELENA | |
| 78 | </city> | |
| 79 | <state> | |
| 80 | AL | |
| 81 | </state> | |
| 82 | <postalCod e> | |
| 83 | 35080 | |
| 84 | </postalCo de> | |
| 85 | <country> | |
| 86 | USA | |
| 87 | </country> | |
| 88 | </addr> | |
| 89 | <telecom | |
| 90 | use="HP" | |
| 91 | value="tel :+1-303-02 1-6133" | |
| 92 | /> | |
| 93 | <patient> | |
| 94 | <name | |
| 95 | use="L" | |
| 96 | > | |
| 97 | <given> | |
| 98 | Nwhinone | |
| 99 | </given> | |
| 100 | <family> | |
| 101 | Nwhinzzzte stpatient | |
| 102 | </family> | |
| 103 | </name> | |
| 104 | <administr ativeGende rCode | |
| 105 | code="M" | |
| 106 | codeSystem ="2.16.840 .1.113883. 5.1" | |
| 107 | codeSystem Name="Admi nistrative GenderCode " | |
| 108 | displayNam e="Male" | |
| 109 | /> | |
| 110 | <birthTime | |
| 111 | value="198 10101" | |
| 112 | /> | |
| 113 | <maritalSt atusCode | |
| 114 | nullFlavor ="UNK" | |
| 115 | /> | |
| 116 | <raceCode | |
| 117 | nullFlavor ="UNK" | |
| 118 | /> | |
| 119 | <ethnicGro upCode | |
| 120 | nullFlavor ="UNK" | |
| 121 | /> | |
| 122 | <languageC ommunicati on> | |
| 123 | <languageC ode | |
| 124 | nullFlavor ="UNK" | |
| 125 | /> | |
| 126 | </language Communicat ion> | |
| 127 | </patient> | |
| 128 | <providerO rganizatio n> | |
| 129 | <id | |
| 130 | root="1.2. 840.114350 .1.13.112. 3.7.2.6888 79" | |
| 131 | extension= "5700" | |
| 132 | /> | |
| 133 | <name> | |
| 134 | Kaiser Per manente Co lorado Tes ting | |
| 135 | </name> | |
| 136 | <telecom | |
| 137 | use="WP" | |
| 138 | value="tel :+1-303-40 4-4200" | |
| 139 | /> | |
| 140 | <addr> | |
| 141 | <streetAdd ressLine> | |
| 142 | 6560 Green wood Plaza Blvd | |
| 143 | </streetAd dressLine> | |
| 144 | <city> | |
| 145 | Greenwood Village | |
| 146 | </city> | |
| 147 | <state> | |
| 148 | CO | |
| 149 | </state> | |
| 150 | <postalCod e> | |
| 151 | 80111 | |
| 152 | </postalCo de> | |
| 153 | <country> | |
| 154 | USA | |
| 155 | </country> | |
| 156 | </addr> | |
| 157 | </provider Organizati on> | |
| 158 | </patientR ole> | |
| 159 | </recordTa rget> | |
| 160 | <author> | |
| 161 | <time | |
| 162 | value="201 6120114550 3-0700" | |
| 163 | /> | |
| 164 | <assignedA uthor> | |
| 165 | <id | |
| 166 | root="1.2. 840.114350 .1.1" | |
| 167 | extension= "8.2" | |
| 168 | /> | |
| 169 | <addr | |
| 170 | nullFlavor ="NA" | |
| 171 | /> | |
| 172 | <telecom | |
| 173 | nullFlavor ="NA" | |
| 174 | /> | |
| 175 | <assignedA uthoringDe vice> | |
| 176 | <manufactu rerModelNa me> | |
| 177 | Epic - Ver sion 8.2 | |
| 178 | </manufact urerModelN ame> | |
| 179 | <softwareN ame> | |
| 180 | Epic - Ver sion 8.2 | |
| 181 | </software Name> | |
| 182 | </assigned AuthoringD evice> | |
| 183 | <represent edOrganiza tion> | |
| 184 | <id | |
| 185 | root="1.2. 840.114350 .1.13.112. 3.7.2.6888 79" | |
| 186 | extension= "5700" | |
| 187 | /> | |
| 188 | <name> | |
| 189 | Kaiser Per manente Co lorado Tes ting | |
| 190 | </name> | |
| 191 | <telecom | |
| 192 | use="WP" | |
| 193 | value="tel :+1-303-40 4-4200" | |
| 194 | /> | |
| 195 | <addr> | |
| 196 | <streetAdd ressLine> | |
| 197 | 6560 Green wood Plaza Blvd | |
| 198 | </streetAd dressLine> | |
| 199 | <city> | |
| 200 | Greenwood Village | |
| 201 | </city> | |
| 202 | <state> | |
| 203 | CO | |
| 204 | </state> | |
| 205 | <postalCod e> | |
| 206 | 80111 | |
| 207 | </postalCo de> | |
| 208 | <country> | |
| 209 | USA | |
| 210 | </country> | |
| 211 | </addr> | |
| 212 | </represen tedOrganiz ation> | |
| 213 | </assigned Author> | |
| 214 | </author> | |
| 215 | <custodian > | |
| 216 | <assignedC ustodian> | |
| 217 | <represent edCustodia nOrganizat ion> | |
| 218 | <id | |
| 219 | root="1.2. 840.114350 .1.13.112. 3.7.2.6888 79" | |
| 220 | extension= "5700" | |
| 221 | /> | |
| 222 | <name> | |
| 223 | Kaiser Per manente Co lorado Tes ting | |
| 224 | </name> | |
| 225 | <telecom | |
| 226 | use="WP" | |
| 227 | value="tel :+1-303-40 4-4200" | |
| 228 | /> | |
| 229 | <addr> | |
| 230 | <streetAdd ressLine> | |
| 231 | 6560 Green wood Plaza Blvd | |
| 232 | </streetAd dressLine> | |
| 233 | <city> | |
| 234 | Greenwood Village | |
| 235 | </city> | |
| 236 | <state> | |
| 237 | CO | |
| 238 | </state> | |
| 239 | <postalCod e> | |
| 240 | 80111 | |
| 241 | </postalCo de> | |
| 242 | <country> | |
| 243 | USA | |
| 244 | </country> | |
| 245 | </addr> | |
| 246 | </represen tedCustodi anOrganiza tion> | |
| 247 | </assigned Custodian> | |
| 248 | </custodia n> | |
| 249 | <documenta tionOf | |
| 250 | typeCode=" DOC" | |
| 251 | > | |
| 252 | <serviceEv ent | |
| 253 | classCode= "PCPR" | |
| 254 | > | |
| 255 | <effective Time> | |
| 256 | <low | |
| 257 | value="186 61130" | |
| 258 | /> | |
| 259 | <high | |
| 260 | value="201 61201" | |
| 261 | /> | |
| 262 | </effectiv eTime> | |
| 263 | <performer | |
| 264 | typeCode=" PRF" | |
| 265 | > | |
| 266 | <functionC ode | |
| 267 | code="PCP" | |
| 268 | codeSystem ="2.16.840 .1.113883. 5.88" | |
| 269 | codeSystem Name="Part icipationF unction" | |
| 270 | displayNam e="Primary Care Prov ider" | |
| 271 | > | |
| 272 | <originalT ext> | |
| 273 | Primary Ca re Provide r | |
| 274 | </original Text> | |
| 275 | </function Code> | |
| 276 | <time> | |
| 277 | <low | |
| 278 | nullFlavor ="NI" | |
| 279 | /> | |
| 280 | <high | |
| 281 | nullFlavor ="PINF" | |
| 282 | /> | |
| 283 | </time> | |
| 284 | <assignedE ntity | |
| 285 | nullFlavor ="NI" | |
| 286 | > | |
| 287 | <id | |
| 288 | nullFlavor ="UNK" | |
| 289 | /> | |
| 290 | <addr | |
| 291 | nullFlavor ="NA" | |
| 292 | /> | |
| 293 | <telecom | |
| 294 | nullFlavor ="NA" | |
| 295 | /> | |
| 296 | <assignedP erson | |
| 297 | nullFlavor ="NA" | |
| 298 | > | |
| 299 | <name | |
| 300 | nullFlavor ="NA" | |
| 301 | /> | |
| 302 | </assigned Person> | |
| 303 | </assigned Entity> | |
| 304 | </performe r> | |
| 305 | </serviceE vent> | |
| 306 | </document ationOf> | |
| 307 | <relatedDo cument | |
| 308 | typeCode=" RPLC" | |
| 309 | > | |
| 310 | <parentDoc ument> | |
| 311 | <id | |
| 312 | assigningA uthorityNa me="EPC" | |
| 313 | root="1.2. 840.114350 .1.13.112. 3.7.8.6888 83.7121987 2" | |
| 314 | /> | |
| 315 | </parentDo cument> | |
| 316 | </relatedD ocument> | |
| 317 | <component > | |
| 318 | <structure dBody> | |
| 319 | <component > | |
| 320 | <section> | |
| 321 | <code | |
| 322 | code="X-DO CCMT" | |
| 323 | codeSystem ="1.2.840. 114350.1.7 2.2" | |
| 324 | displayNam e="Documen t Comments " | |
| 325 | /> | |
| 326 | <title> | |
| 327 | Source Com ments | |
| 328 | </title> | |
| 329 | <text> | |
| 330 | NOTE: The informatio n displaye d by Care Epic is ex tracted fr om the com pletemedic al record and may no t identify all curre nt or past patient c onditions. Seebelow for furthe r instruct ions regar ding Menta l Health a nd CDRP pa tients. | |
| 331 | <footnote> | |
| 332 | Kaiser Per manente Co lorado Tes ting | |
| 333 | </footnote > | |
| 334 | </text> | |
| 335 | </section> | |
| 336 | </componen t> | |
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| 338 | <section | |
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| 349 | root="2.16 .840.1.113 883.10.20. 22.2.6" | |
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| 371 | Not on Fil e | |
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| 407 | <content | |
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| 443 | Active Pro blems | |
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| 446 | <paragraph | |
| 447 | ID="nof7" | |
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| 449 | Not on fil e | |
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| 454 | <component > | |
| 455 | <section> | |
| 456 | <templateI d | |
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| 473 | codeSystem Name="LOIN C" | |
| 474 | displayNam e="HISTORY OF ENCOUN TERS" | |
| 475 | /> | |
| 476 | <title> | |
| 477 | Encounters | |
| 478 | </title> | |
| 479 | <text> | |
| 480 | <table> | |
| 481 | <colgroup> | |
| 482 | <col | |
| 483 | width="10% " | |
| 484 | /> | |
| 485 | <col | |
| 486 | width="15% " | |
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| 488 | <col | |
| 489 | width="25% " | |
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| 492 | width="25% " | |
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| 495 | width="25% " | |
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| 499 | <tr> | |
| 500 | <th> | |
| 501 | Date | |
| 502 | </th> | |
| 503 | <th> | |
| 504 | Type | |
| 505 | </th> | |
| 506 | <th> | |
| 507 | Specialty | |
| 508 | </th> | |
| 509 | <th> | |
| 510 | Care Team | |
| 511 | </th> | |
| 512 | <th> | |
| 513 | Descriptio n | |
| 514 | </th> | |
| 515 | </tr> | |
| 516 | </thead> | |
| 517 | <tbody> | |
| 518 | <tr | |
| 519 | ID="encoun ter10" | |
| 520 | styleCode= "normRow" | |
| 521 | > | |
| 522 | <td> | |
| 523 | 11/04/2016 | |
| 524 | </td> | |
| 525 | <td | |
| 526 | ID="encoun ter10type" | |
| 527 | > | |
| 528 | Orders Onl y | |
| 529 | </td> | |
| 530 | <td | |
| 531 | ID="encoun ter10speci alty" | |
| 532 | > | |
| 533 | Internal M edicine | |
| 534 | </td> | |
| 535 | <td> | |
| 536 | <paragraph > | |
| 537 | Testdoc, P rova | |
| 538 | </paragrap h> | |
| 539 | </td> | |
| 540 | <td /> | |
| 541 | </tr> | |
| 542 | <tr | |
| 543 | ID="encoun ter11" | |
| 544 | styleCode= "altRow" | |
| 545 | > | |
| 546 | <td> | |
| 547 | 10/24/2016 | |
| 548 | </td> | |
| 549 | <td | |
| 550 | ID="encoun ter11type" | |
| 551 | > | |
| 552 | Orders Onl y | |
| 553 | </td> | |
| 554 | <td | |
| 555 | ID="encoun ter11speci alty" | |
| 556 | > | |
| 557 | Internal M edicine | |
| 558 | </td> | |
| 559 | <td> | |
| 560 | <paragraph > | |
| 561 | Testdoc, P rova | |
| 562 | </paragrap h> | |
| 563 | </td> | |
| 564 | <td /> | |
| 565 | </tr> | |
| 566 | </tbody> | |
| 567 | </table> | |
| 568 | <footnote | |
| 569 | ID="subTit le9" | |
| 570 | styleCode= "xSectionS ubTitle xH idden" | |
| 571 | > | |
| 572 | after 11/3 0/1866 | |
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| 575 | <entry> | |
| 576 | <encounter | |
| 577 | classCode= "ENC" | |
| 578 | moodCode=" EVN" | |
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| 580 | <templateI d | |
| 581 | root="2.16 .840.1.113 883.10.20. 22.4.49" | |
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| 585 | extension= "2015-08-0 1" | |
| 586 | /> | |
| 587 | <id | |
| 588 | assigningA uthorityNa me="EPIC" | |
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| 1215 | <td> | |
| 1216 | <paragraph > | |
| 1217 | 2500 S HA D ANA
|
|
| 1218 | < paragraph> | |
| 1219 | <paragraph > | |
| 1220 | AURORA, CO 80014 | |
| 1221 | </paragrap h> | |
| 1222 | </td> | |
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| 1248 | <tr> | |
| 1249 | <th> | |
| 1250 | Guarantor Name | |
| 1251 | </th> | |
| 1252 | <th> | |
| 1253 | Account Ty pe | |
| 1254 | </th> | |
| 1255 | <th> | |
| 1256 | Relation t o Patient | |
| 1257 | </th> | |
| 1258 | <th> | |
| 1259 | Date of Bi rth | |
| 1260 | </th> | |
| 1261 | <th> | |
| 1262 | Phone | |
| 1263 | </th> | |
| 1264 | <th> | |
| 1265 | Billing Ad dress | |
| 1266 | </th> | |
| 1267 | </tr> | |
| 1268 | </thead> | |
| 1269 | <tbody> | |
| 1270 | <tr> | |
| 1271 | <td> | |
| 1272 | TSIXANTHON ER,TSIXANT HONER | |
| 1273 | </td> | |
| 1274 | <td> | |
| 1275 | Personal/F amily | |
| 1276 | </td> | |
| 1277 | <td> | |
| 1278 | Self | |
| 1279 | </td> | |
| 1280 | <td> | |
| 1281 | 09/02/2016 | |
| 1282 | </td> | |
| 1283 | <td> | |
| 1284 | <paragraph > | |
| 1285 | Home: +1-3 03-021-613 3 | |
| 1286 | </paragrap h> | |
| 1287 | </td> | |
| 1288 | <td> | |
| 1289 | <paragraph > | |
| 1290 | 44 16TH ST REET | |
| 1291 | </paragrap h> | |
| 1292 | <paragraph > | |
| 1293 | DENVER, CO 80202 | |
| 1294 | </paragrap h> | |
| 1295 | </td> | |
| 1296 | </tr> | |
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|
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| 1387 | KAISER PER M DEN-BOU | |
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|
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| 1403 | 80014 | |
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| 1406 | </represen tedOrganiz ation> | |
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| 1408 | </performe r> | |
| 1409 | <participa nt | |
| 1410 | typeCode=" COV" | |
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| 1421 | </act> | |
| 1422 | </entry> | |
| 1423 | </section> | |
| 1424 | </componen t> | |
| 1425 | <component > | |
| 1426 | <section> | |
| 1427 | <code | |
| 1428 | code="X-DO CCMTADDL" | |
| 1429 | codeSystem ="1.2.840. 114350.1.7 2.2" | |
| 1430 | displayNam e="Additio nal Docume nt Comment s" | |
| 1431 | /> | |
| 1432 | <title> | |
| 1433 | Additional Source Co mments | |
| 1434 | </title> | |
| 1435 | <text> | |
| 1436 | NOTE: The informatio n displaye d by Care Epic is ex tracted fr om the com plete medi cal record and may n ot identif y all curr ent or pas t patient conditions . FOR RECO RDS PERTAI NING TO PA TIENTS WHO ARE OR HA VE BEEN EN ROLLED IN A CHEMICAL DEPENDENC Y/SUBSTANC E ABUSE PR OGRAM - PL EASE NOTE: Some of t he enclose d informat ion may co ntain reco rds from t he patient 's treatme nt in a su bstance ab use progra m that are protected by Federa l confiden tiality ru les (42 CF R part 2). The Feder al rules p rohibit yo u from mak ing any fu rther disc losure of this infor mation unl ess furthe r disclosu re is expr essly perm itted by t he written consent o f the pers on to whom it pertai ns or as o therwise p ermitted b y 42 CFR p art 2. A g eneral aut horization for the r elease of medical or other inf ormation i s NOT suff icient for this purp ose. The F ederal rul es restric t any use of the inf ormation t o criminal ly investi gate or pr osecute an y alcohol or drug ab use patien t. | |
| 1437 | <footnote> | |
| 1438 | Kaiser Per manente Co lorado Tes ting | |
| 1439 | </footnote > | |
| 1440 | </text> | |
| 1441 | </section> | |
| 1442 | </componen t> | |
| 1443 | </structur edBody> | |
| 1444 | </componen t> | |
| 1445 | </Clinical Document> |
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