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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\Vermont Information Technology | 374228_C32_20161206.xml | Thu Jan 12 19:48:46 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\Vermont Information Technology | 374228_C32_20161206.xml | Mon Apr 3 14:15:36 2017 UTC |
| Description | Between Files 1 and 2 |
|
|---|---|---|
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| Unchanged | 21 | 5412 |
| Changed | 20 | 40 |
| Inserted | 0 | 0 |
| Removed | 0 | 0 |
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|---|---|
| Character case | Differences in character case are significant |
| Line endings | Differences in line endings (CR and LF characters) are ignored |
| CR/LF characters | Not shown in the comparison detail |
No regular expressions were active.
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| 689 | root="2.16 .840.1.113 883.3.579. 2.64" | |
| 690 | extension= "637967" | |
| 691 | assigningA uthorityNa me="VITL P ractice Re pository" | |
| 692 | /> | |
| 693 | ||
| 694 | </patient> | |
| 695 | ||
| 696 | </assigned Entity> | |
| 697 | ||
| 698 | </performe r> | |
| 699 | ||
| 700 | <performer | |
| 701 | typeCode=" PRF" | |
| 702 | > | |
| 703 | ||
| 704 | <templateI d | |
| 705 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.2.3" | |
| 706 | /> | |
| 707 | ||
| 708 | <functionC ode | |
| 709 | code="CP" | |
| 710 | codeSystem ="2.16.840 .1.113883. 12.443" | |
| 711 | displayNam e="CONSULT ING" | |
| 712 | /> | |
| 713 | ||
| 714 | <time> | |
| 715 | ||
| 716 | <low | |
| 717 | value="201 6060915282 7-0600" | |
| 718 | /> | |
| 719 | ||
| 720 | <high | |
| 721 | nullFlavor ="NA" | |
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| 723 | ||
| 724 | </time> | |
| 725 | ||
| 726 | <assignedE ntity | |
| 727 | classCode= "ASSIGNED" | |
| 728 | > | |
| 729 | ||
| 730 | <id | |
| 731 | root="4586 97589856NP I" | |
| 732 | extension= "458697589 856" | |
| 733 | assigningA uthorityNa me="VITL P ractice" | |
| 734 | /> | |
| 735 | ||
| 736 | <code | |
| 737 | code="2000 00000X" | |
| 738 | codeSystem ="2.16.840 .1.113883. 6.101" | |
| 739 | codeSystem Name="NUCC " | |
| 740 | displayNam e="Allopat hic & Osteopathi c Physicia ns" | |
| 741 | /> | |
| 742 | ||
| 743 | <addr | |
| 744 | nullFlavor ="NA" | |
| 745 | use="WP" | |
| 746 | /> | |
| 747 | ||
| 748 | <telecom | |
| 749 | nullFlavor ="NA" | |
| 750 | /> | |
| 751 | ||
| 752 | <assignedP erson | |
| 753 | classCode= "PSN" | |
| 754 | determiner Code="INST ANCE" | |
| 755 | > | |
| 756 | ||
| 757 | <name> | |
| 758 | ||
| 759 | <given> | |
| 760 | Doctor | |
| 761 | </given> | |
| 762 | ||
| 763 | <family> | |
| 764 | Test DO | |
| 765 | </family> | |
| 766 | ||
| 767 | </name> | |
| 768 | ||
| 769 | </assigned Person> | |
| 770 | ||
| 771 | <represent edOrganiza tion | |
| 772 | classCode= "ORG" | |
| 773 | determiner Code="INST ANCE" | |
| 774 | > | |
| 775 | ||
| 776 | <id | |
| 777 | root="4586 97589856NP I" | |
| 778 | /> | |
| 779 | ||
| 780 | <name> | |
| 781 | VITL Pract ice | |
| 782 | </name> | |
| 783 | ||
| 784 | <telecom | |
| 785 | nullFlavor ="NA" | |
| 786 | /> | |
| 787 | ||
| 788 | <addr | |
| 789 | nullFlavor ="NA" | |
| 790 | use="WP" | |
| 791 | /> | |
| 792 | ||
| 793 | </represen tedOrganiz ation> | |
| 794 | ||
| 795 | <patient | |
| 796 | xmlns="urn :hl7-org:s dtc" | |
| 797 | > | |
| 798 | ||
| 799 | <id | |
| 800 | root="2.16 .840.1.113 883.3.579. 2.64" | |
| 801 | extension= "637967" | |
| 802 | assigningA uthorityNa me="VITL P ractice Re pository" | |
| 803 | /> | |
| 804 | ||
| 805 | </patient> | |
| 806 | ||
| 807 | </assigned Entity> | |
| 808 | ||
| 809 | </performe r> | |
| 810 | ||
| 811 | </serviceE vent> | |
| 812 | ||
| 813 | </document ationOf> | |
| 814 | ||
| 815 | <component > | |
| 816 | ||
| 817 | <structure dBody | |
| 818 | classCode= "DOCBODY" | |
| 819 | moodCode=" EVN" | |
| 820 | > | |
| 821 | ||
| 822 | <component > | |
| 823 | ||
| 824 | <section | |
| 825 | classCode= "DOCSECT" | |
| 826 | moodCode=" EVN" | |
| 827 | > | |
| 828 | ||
| 829 | <templateI d | |
| 830 | root="2.16 .840.1.113 883.3.88.1 1.83.103" | |
| 831 | assigningA uthorityNa me="HISTP C83" | |
| 832 | /> | |
| 833 | ||
| 834 | <templateI d | |
| 835 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.3.6" | |
| 836 | assigningA uthorityNa me="CCD" | |
| 837 | /> | |
| 838 | ||
| 839 | <templateI d | |
| 840 | root="2.16 .840.1.113 883. IP " | |
| 841 | assigningA uthorityNa me="CCD" | |
| 842 | /> | |
| 843 | ||
| 844 | <code | |
| 845 | code="1145 0-4" | |
| 846 | codeSystem ="2.16.840 .1.113883. 6.1" | |
| 847 | codeSystem Name="LOIN C" | |
| 848 | displayNam e="Problem List" | |
| 849 | > | |
| 850 | ||
| 851 | <originalT ext> | |
| 852 | PROBLEMS | |
| 853 | </original Text> | |
| 854 | ||
| 855 | </code> | |
| 856 | ||
| 857 | <title> | |
| 858 | PROBLEMS | |
| 859 | </title> | |
| 860 | ||
| 861 | <text | |
| 862 | mediaType= "text/x-hl 7-text+xml " | |
| 863 | > | |
| 864 | No Problem Records F ound | |
| 865 | </text> | |
| 866 | ||
| 867 | <entry | |
| 868 | typeCode=" DRIV" | |
| 869 | > | |
| 870 | ||
| 871 | <act | |
| 872 | classCode= "ACT" | |
| 873 | moodCode=" EVN" | |
| 874 | > | |
| 875 | ||
| 876 | <templateI d | |
| 877 | root="2.16 .840.1.113 883. IP " | |
| 878 | /> | |
| 879 | ||
| 880 | <templateI d | |
| 881 | root="2.16 .840.1.113 883.3.88.1 1.83.7" | |
| 882 | /> | |
| 883 | ||
| 884 | <templateI d | |
| 885 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.5.1" | |
| 886 | /> | |
| 887 | ||
| 888 | <templateI d | |
| 889 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.5.2" | |
| 890 | /> | |
| 891 | ||
| 892 | <id | |
| 893 | nullFlavor ="NA" | |
| 894 | /> | |
| 895 | ||
| 896 | <code | |
| 897 | nullFlavor ="NA" | |
| 898 | /> | |
| 899 | ||
| 900 | <statusCod e | |
| 901 | code="susp ended" | |
| 902 | /> | |
| 903 | ||
| 904 | <effective Time> | |
| 905 | ||
| 906 | <low | |
| 907 | nullFlavor ="UNK" | |
| 908 | /> | |
| 909 | ||
| 910 | </effectiv eTime> | |
| 911 | ||
| 912 | <entryRela tionship | |
| 913 | typeCode=" SUBJ" | |
| 914 | inversionI nd="false" | |
| 915 | > | |
| 916 | ||
| 917 | <observati on | |
| 918 | classCode= "OBS" | |
| 919 | moodCode=" EVN" | |
| 920 | > | |
| 921 | ||
| 922 | <templateI d | |
| 923 | root="2.16 .840.1.113 883. IP " | |
| 924 | assigningA uthorityNa me="CCD" | |
| 925 | /> | |
| 926 | ||
| 927 | <templateI d | |
| 928 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.5" | |
| 929 | assigningA uthorityNa me="IHE PC C" | |
| 930 | /> | |
| 931 | ||
| 932 | <templateI d | |
| 933 | root="2.16 .840.1.113 883. IP " | |
| 934 | assigningA uthorityNa me="CCD" | |
| 935 | /> | |
| 936 | ||
| 937 | <id | |
| 938 | nullFlavor ="NA" | |
| 939 | /> | |
| 940 | ||
| 941 | <code | |
| 942 | code="2822 91009" | |
| 943 | codeSystem ="2.16.840 .1.113883. 6.96" | |
| 944 | codeSystem Name="SNOM ED CT" | |
| 945 | displayNam e="Diagnos is" | |
| 946 | /> | |
| 947 | ||
| 948 | <text> | |
| 949 | ||
| 950 | <reference | |
| 951 | value="PRO B_NO" | |
| 952 | /> | |
| 953 | ||
| 954 | </text> | |
| 955 | ||
| 956 | <statusCod e | |
| 957 | code="comp leted" | |
| 958 | /> | |
| 959 | ||
| 960 | <effective Time> | |
| 961 | ||
| 962 | <low | |
| 963 | nullFlavor ="UNK" | |
| 964 | /> | |
| 965 | ||
| 966 | </effectiv eTime> | |
| 967 | ||
| 968 | <value | |
| 969 | xsi:type=" CD" | |
| 970 | nullFlavor ="NA" | |
| 971 | > | |
| 972 | ||
| 973 | <originalT ext> | |
| 974 | No Problem Records F ound | |
| 975 | <reference | |
| 976 | value="" | |
| 977 | /> | |
| 978 | </original Text> | |
| 979 | ||
| 980 | </value> | |
| 981 | ||
| 982 | </observat ion> | |
| 983 | ||
| 984 | </entryRel ationship> | |
| 985 | ||
| 986 | </act> | |
| 987 | ||
| 988 | </entry> | |
| 989 | ||
| 990 | </section> | |
| 991 | ||
| 992 | </componen t> | |
| 993 | ||
| 994 | <component > | |
| 995 | ||
| 996 | <section | |
| 997 | classCode= "DOCSECT" | |
| 998 | moodCode=" EVN" | |
| 999 | > | |
| 1000 | ||
| 1001 | <templateI d | |
| 1002 | root="2.16 .840.1.113 883. IP " | |
| 1003 | /> | |
| 1004 | ||
| 1005 | <templateI d | |
| 1006 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.3.11" | |
| 1007 | /> | |
| 1008 | ||
| 1009 | <id | |
| 1010 | nullFlavor ="NA" | |
| 1011 | /> | |
| 1012 | ||
| 1013 | <code | |
| 1014 | code="4751 9-4" | |
| 1015 | codeSystem ="2.16.840 .1.113883. 6.1" | |
| 1016 | codeSystem Name="LOIN C" | |
| 1017 | displayNam e="History of Proced ures" | |
| 1018 | > | |
| 1019 | ||
| 1020 | <originalT ext> | |
| 1021 | PROCEDURES | |
| 1022 | </original Text> | |
| 1023 | ||
| 1024 | </code> | |
| 1025 | ||
| 1026 | <title> | |
| 1027 | PROCEDURES | |
| 1028 | </title> | |
| 1029 | ||
| 1030 | <text | |
| 1031 | mediaType= "text/x-hl 7-text+xml " | |
| 1032 | > | |
| 1033 | No Procedu re Records Found | |
| 1034 | </text> | |
| 1035 | ||
| 1036 | </section> | |
| 1037 | ||
| 1038 | </componen t> | |
| 1039 | ||
| 1040 | <component > | |
| 1041 | ||
| 1042 | <section | |
| 1043 | classCode= "DOCSECT" | |
| 1044 | moodCode=" EVN" | |
| 1045 | > | |
| 1046 | ||
| 1047 | <templateI d | |
| 1048 | root="2.16 .840.1.113 883. IP " | |
| 1049 | /> | |
| 1050 | ||
| 1051 | <templateI d | |
| 1052 | root="2.16 .840.1.113 883.3.88.1 1.83.122" | |
| 1053 | /> | |
| 1054 | ||
| 1055 | <templateI d | |
| 1056 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.3.28" | |
| 1057 | /> | |
| 1058 | ||
| 1059 | <code | |
| 1060 | code="3095 4-2" | |
| 1061 | codeSystem ="2.16.840 .1.113883. 6.1" | |
| 1062 | codeSystem Name="LOIN C" | |
| 1063 | displayNam e="Relevan t diagnost ic tests a nd/or labo ratory dat a" | |
| 1064 | > | |
| 1065 | ||
| 1066 | <originalT ext> | |
| 1067 | RESULTS | |
| 1068 | </original Text> | |
| 1069 | ||
| 1070 | </code> | |
| 1071 | ||
| 1072 | <title> | |
| 1073 | RESULTS | |
| 1074 | </title> | |
| 1075 | ||
| 1076 | <text | |
| 1077 | mediaType= "text/x-hl 7-text+xml " | |
| 1078 | > | |
| 1079 | No Result Records Fo und | |
| 1080 | </text> | |
| 1081 | ||
| 1082 | <entry | |
| 1083 | typeCode=" DRIV" | |
| 1084 | > | |
| 1085 | ||
| 1086 | <organizer | |
| 1087 | classCode= "BATTERY" | |
| 1088 | moodCode=" EVN" | |
| 1089 | > | |
| 1090 | ||
| 1091 | <templateI d | |
| 1092 | root="2.16 .840.1.113 883. IP " | |
| 1093 | /> | |
| 1094 | ||
| 1095 | <id | |
| 1096 | nullFlavor ="UNK" | |
| 1097 | /> | |
| 1098 | ||
| 1099 | <code | |
| 1100 | nullFlavor ="UNK" | |
| 1101 | /> | |
| 1102 | ||
| 1103 | <statusCod e | |
| 1104 | code="comp leted" | |
| 1105 | /> | |
| 1106 | ||
| 1107 | <effective Time | |
| 1108 | nullFlavor ="UNK" | |
| 1109 | /> | |
| 1110 | ||
| 1111 | <component > | |
| 1112 | ||
| 1113 | <procedure | |
| 1114 | classCode= "PROC" | |
| 1115 | moodCode=" EVN" | |
| 1116 | > | |
| 1117 | ||
| 1118 | <templateI d | |
| 1119 | root="2.16 .840.1.113 883.3.88.1 1.83.17" | |
| 1120 | assigningA uthorityNa me="HITSP C83" | |
| 1121 | /> | |
| 1122 | ||
| 1123 | <templateI d | |
| 1124 | root="2.16 .840.1.113 883. IP " | |
| 1125 | assigningA uthorityNa me="CCD" | |
| 1126 | /> | |
| 1127 | ||
| 1128 | <templateI d | |
| 1129 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.19" | |
| 1130 | assigningA uthorityNa me="IHE PC C" | |
| 1131 | /> | |
| 1132 | ||
| 1133 | <id | |
| 1134 | nullFlavor ="UNK" | |
| 1135 | /> | |
| 1136 | ||
| 1137 | <code | |
| 1138 | nullFlavor ="UNK" | |
| 1139 | > | |
| 1140 | ||
| 1141 | <originalT ext> | |
| 1142 | ||
| 1143 | <reference | |
| 1144 | value="" | |
| 1145 | /> | |
| 1146 | ||
| 1147 | </original Text> | |
| 1148 | ||
| 1149 | </code> | |
| 1150 | ||
| 1151 | <text | |
| 1152 | nullFlavor ="UNK" | |
| 1153 | > | |
| 1154 | ||
| 1155 | <reference | |
| 1156 | value="" | |
| 1157 | /> | |
| 1158 | ||
| 1159 | </text> | |
| 1160 | ||
| 1161 | <statusCod e | |
| 1162 | code="comp leted" | |
| 1163 | /> | |
| 1164 | ||
| 1165 | <effective Time | |
| 1166 | nullFlavor ="UNK" | |
| 1167 | /> | |
| 1168 | ||
| 1169 | </procedur e> | |
| 1170 | ||
| 1171 | </componen t> | |
| 1172 | ||
| 1173 | <component > | |
| 1174 | ||
| 1175 | <observati on | |
| 1176 | classCode= "OBS" | |
| 1177 | moodCode=" EVN" | |
| 1178 | > | |
| 1179 | ||
| 1180 | <templateI d | |
| 1181 | root="2.16 .840.1.113 883.3.88.1 1.83.15.1" | |
| 1182 | /> | |
| 1183 | ||
| 1184 | <templateI d | |
| 1185 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.13" | |
| 1186 | /> | |
| 1187 | ||
| 1188 | <templateI d | |
| 1189 | root="2.16 .840.1.113 883. IP " | |
| 1190 | /> | |
| 1191 | ||
| 1192 | <id | |
| 1193 | nullFlavor ="NA" | |
| 1194 | /> | |
| 1195 | ||
| 1196 | <code | |
| 1197 | code="NA" | |
| 1198 | codeSystem ="2.16.840 .1.113883. 3.579" | |
| 1199 | codeSystem Name="LOCA L" | |
| 1200 | > | |
| 1201 | ||
| 1202 | <originalT ext> | |
| 1203 | No Result Records Fo und | |
| 1204 | <reference | |
| 1205 | value="" | |
| 1206 | /> | |
| 1207 | </original Text> | |
| 1208 | ||
| 1209 | </code> | |
| 1210 | ||
| 1211 | <text> | |
| 1212 | ||
| 1213 | <reference | |
| 1214 | value="" | |
| 1215 | /> | |
| 1216 | ||
| 1217 | </text> | |
| 1218 | ||
| 1219 | <statusCod e | |
| 1220 | code="comp leted" | |
| 1221 | /> | |
| 1222 | ||
| 1223 | <effective Time | |
| 1224 | nullFlavor ="NA" | |
| 1225 | /> | |
| 1226 | ||
| 1227 | <value | |
| 1228 | xsi:type=" CV" | |
| 1229 | nullFlavor ="NA" | |
| 1230 | > | |
| 1231 | ||
| 1232 | <originalT ext> | |
| 1233 | ||
| 1234 | <reference | |
| 1235 | value="" | |
| 1236 | /> | |
| 1237 | ||
| 1238 | </original Text> | |
| 1239 | ||
| 1240 | </value> | |
| 1241 | ||
| 1242 | </observat ion> | |
| 1243 | ||
| 1244 | </componen t> | |
| 1245 | ||
| 1246 | </organize r> | |
| 1247 | ||
| 1248 | </entry> | |
| 1249 | ||
| 1250 | </section> | |
| 1251 | ||
| 1252 | </componen t> | |
| 1253 | ||
| 1254 | <component > | |
| 1255 | ||
| 1256 | <section | |
| 1257 | classCode= "DOCSECT" | |
| 1258 | moodCode=" EVN" | |
| 1259 | > | |
| 1260 | ||
| 1261 | <templateI d | |
| 1262 | root="2.16 .840.1.113 883. IP " | |
| 1263 | /> | |
| 1264 | ||
| 1265 | <templateI d | |
| 1266 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.3.13" | |
| 1267 | /> | |
| 1268 | ||
| 1269 | <templateI d | |
| 1270 | root="2.16 .840.1.113 883.3.88.1 1.83.102" | |
| 1271 | /> | |
| 1272 | ||
| 1273 | <code | |
| 1274 | code="4876 5-2" | |
| 1275 | codeSystem ="2.16.840 .1.113883. 6.1" | |
| 1276 | codeSystem Name="LOIN C" | |
| 1277 | displayNam e="Allergi es" | |
| 1278 | > | |
| 1279 | ||
| 1280 | <originalT ext> | |
| 1281 | ALLERGIES | |
| 1282 | </original Text> | |
| 1283 | ||
| 1284 | </code> | |
| 1285 | ||
| 1286 | <title> | |
| 1287 | ALLERGIES | |
| 1288 | </title> | |
| 1289 | ||
| 1290 | <text | |
| 1291 | mediaType= "text/x-hl 7-text+xml " | |
| 1292 | > | |
| 1293 | No Allergi es Records Found | |
| 1294 | </text> | |
| 1295 | ||
| 1296 | <entry> | |
| 1297 | ||
| 1298 | <act | |
| 1299 | classCode= "ACT" | |
| 1300 | moodCode=" EVN" | |
| 1301 | > | |
| 1302 | ||
| 1303 | <templateI d | |
| 1304 | root="2.16 .840.1.113 883. IP " | |
| 1305 | /> | |
| 1306 | ||
| 1307 | <templateI d | |
| 1308 | root="2.16 .840.1.113 883.3.88.1 1.83.6" | |
| 1309 | /> | |
| 1310 | ||
| 1311 | <templateI d | |
| 1312 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.5.1" | |
| 1313 | /> | |
| 1314 | ||
| 1315 | <templateI d | |
| 1316 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.5.3" | |
| 1317 | /> | |
| 1318 | ||
| 1319 | <id | |
| 1320 | nullFlavor ="NA" | |
| 1321 | /> | |
| 1322 | ||
| 1323 | <code | |
| 1324 | nullFlavor ="NA" | |
| 1325 | /> | |
| 1326 | ||
| 1327 | <statusCod e | |
| 1328 | code="acti ve" | |
| 1329 | /> | |
| 1330 | ||
| 1331 | <effective Time> | |
| 1332 | ||
| 1333 | <low | |
| 1334 | value="201 6102617312 2.744" | |
| 1335 | /> | |
| 1336 | ||
| 1337 | </effectiv eTime> | |
| 1338 | ||
| 1339 | <entryRela tionship | |
| 1340 | typeCode=" SUBJ" | |
| 1341 | inversionI nd="false" | |
| 1342 | > | |
| 1343 | ||
| 1344 | <observati on | |
| 1345 | classCode= "OBS" | |
| 1346 | moodCode=" EVN" | |
| 1347 | > | |
| 1348 | ||
| 1349 | <templateI d | |
| 1350 | root="2.16 .840.1.113 883. IP " | |
| 1351 | /> | |
| 1352 | ||
| 1353 | <templateI d | |
| 1354 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.5" | |
| 1355 | /> | |
| 1356 | ||
| 1357 | <templateI d | |
| 1358 | root="2.16 .840.1.113 883. IP " | |
| 1359 | /> | |
| 1360 | ||
| 1361 | <templateI d | |
| 1362 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.6" | |
| 1363 | /> | |
| 1364 | ||
| 1365 | <id | |
| 1366 | nullFlavor ="NA" | |
| 1367 | /> | |
| 1368 | ||
| 1369 | <code | |
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| 2087 | <th> | |
| 2088 | GUARANTOR | |
| 2089 | </th> | |
| 2090 | ||
| 2091 | <th> | |
| 2092 | PAYER | |
| 2093 | </th> | |
| 2094 | ||
| 2095 | <th> | |
| 2096 | SUBSCRIBER | |
| 2097 | </th> | |
| 2098 | ||
| 2099 | <th> | |
| 2100 | SOURCE | |
| 2101 | </th> | |
| 2102 | ||
| 2103 | </tr> | |
| 2104 | ||
| 2105 | </thead> | |
| 2106 | ||
| 2107 | <tbody> | |
| 2108 | ||
| 2109 | <tr> | |
| 2110 | ||
| 2111 | <td> | |
| 2112 | 06/09/2016 | |
| 2113 | </td> | |
| 2114 | ||
| 2115 | <td | |
| 2116 | styleCode= "PreFormat " | |
| 2117 | > | |
| 2118 | NOT GIVEN | |
| 2119 | ||
| 2120 | ||
| 2121 | </td> | |
| 2122 | ||
| 2123 | <td | |
| 2124 | styleCode= "PreFormat " | |
| 2125 | > | |
| 2126 | Primary In surance: | |
| 2127 | Enterprise | |
| 2128 | PO BOX 123 | |
| 2129 | Test, AL 3 5080 | |
| 2130 | WP: (800) 123-1706 | |
| 2131 | Policy Num ber: | |
| 2132 | Effective Date: | |
| 2133 | ||
| 2134 | ||
| 2135 | Plan Type: | |
| 2136 | D | |
| 2137 | </td> | |
| 2138 | ||
| 2139 | <td | |
| 2140 | styleCode= "PreFormat " | |
| 2141 | > | |
| 2142 | NOT GIVEN | |
| 2143 | UNK | |
| 2144 | </td> | |
| 2145 | ||
| 2146 | <td> | |
| 2147 | VITL Pract ice Reposi tory | |
| 2148 | </td> | |
| 2149 | ||
| 2150 | </tr> | |
| 2151 | ||
| 2152 | </tbody> | |
| 2153 | ||
| 2154 | </table> | |
| 2155 | ||
| 2156 | </text> | |
| 2157 | ||
| 2158 | <entry> | |
| 2159 | ||
| 2160 | <act | |
| 2161 | classCode= "ACT" | |
| 2162 | moodCode=" DEF" | |
| 2163 | > | |
| 2164 | ||
| 2165 | <templateI d | |
| 2166 | root="2.16 .840.1.113 883. IP " | |
| 2167 | /> | |
| 2168 | ||
| 2169 | <templateI d | |
| 2170 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.17" | |
| 2171 | /> | |
| 2172 | ||
| 2173 | <id | |
| 2174 | root="491f cceb-4437- 483b-8fcb- 4e2c31f43e ed" | |
| 2175 | /> | |
| 2176 | ||
| 2177 | <code | |
| 2178 | code="4876 8-6" | |
| 2179 | codeSystem ="2.16.840 .1.113883. 6.1" | |
| 2180 | codeSystem Name="LOIN C" | |
| 2181 | displayNam e="Payment sources" | |
| 2182 | /> | |
| 2183 | ||
| 2184 | <statusCod e | |
| 2185 | code="comp leted" | |
| 2186 | /> | |
| 2187 | ||
| 2188 | <entryRela tionship | |
| 2189 | typeCode=" COMP" | |
| 2190 | > | |
| 2191 | ||
| 2192 | <sequenceN umber /> | |
| 2193 | ||
| 2194 | <act | |
| 2195 | classCode= "ACT" | |
| 2196 | moodCode=" EVN" | |
| 2197 | > | |
| 2198 | ||
| 2199 | <templateI d | |
| 2200 | root="2.16 .840.1.113 883. IP " | |
| 2201 | /> | |
| 2202 | ||
| 2203 | <templateI d | |
| 2204 | root="2.16 .840.1.113 883.3.88.1 1.83.5" | |
| 2205 | /> | |
| 2206 | ||
| 2207 | <templateI d | |
| 2208 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.18" | |
| 2209 | /> | |
| 2210 | ||
| 2211 | <id /> | |
| 2212 | ||
| 2213 | <code | |
| 2214 | xsi:type=" CE" | |
| 2215 | code="D" | |
| 2216 | codeSystem ="2.16.840 .1.113883. 6.255.1336 " | |
| 2217 | codeSystem Name="X12N -1336" | |
| 2218 | displayNam e="Disabil ity" | |
| 2219 | /> | |
| 2220 | ||
| 2221 | <statusCod e | |
| 2222 | code="comp leted" | |
| 2223 | /> | |
| 2224 | ||
| 2225 | <performer | |
| 2226 | typeCode=" PRF" | |
| 2227 | > | |
| 2228 | ||
| 2229 | <time> | |
| 2230 | ||
| 2231 | <low | |
| 2232 | nullFlavor ="NA" | |
| 2233 | /> | |
| 2234 | ||
| 2235 | <high | |
| 2236 | nullFlavor ="NA" | |
| 2237 | /> | |
| 2238 | ||
| 2239 | </time> | |
| 2240 | ||
| 2241 | <assignedE ntity | |
| 2242 | classCode= "ASSIGNED" | |
| 2243 | > | |
| 2244 | ||
| 2245 | <id | |
| 2246 | nullFlavor ="NI" | |
| 2247 | /> | |
| 2248 | ||
| 2249 | <code | |
| 2250 | code="PAYO R" | |
| 2251 | codeSystem ="2.16.840 .1.113883. 5.110" | |
| 2252 | codeSystem Name="Role Class" | |
| 2253 | /> | |
| 2254 | ||
| 2255 | <addr | |
| 2256 | nullFlavor ="NA" | |
| 2257 | use="WP" | |
| 2258 | /> | |
| 2259 | ||
| 2260 | <telecom | |
| 2261 | nullFlavor ="NA" | |
| 2262 | /> | |
| 2263 | ||
| 2264 | <represent edOrganiza tion | |
| 2265 | classCode= "ORG" | |
| 2266 | determiner Code="INST ANCE" | |
| 2267 | > | |
| 2268 | ||
| 2269 | <id /> | |
| 2270 | ||
| 2271 | <name> | |
| 2272 | Enterprise | |
| 2273 | </name> | |
| 2274 | ||
| 2275 | <telecom | |
| 2276 | value="(80 0) 123-170 6" | |
| 2277 | use="WP" | |
| 2278 | /> | |
| 2279 | ||
| 2280 | <addr | |
| 2281 | use="WP" | |
| 2282 | > | |
| 2283 | ||
| 2284 | <streetAdd ressLine> | |
| 2285 | PO BOX 123 | |
| 2286 | </streetAd dressLine> | |
| 2287 | ||
| 2288 | <city> | |
| 2289 | Test | |
| 2290 | </city> | |
| 2291 | ||
| 2292 | <state> | |
| 2293 | AL | |
| 2294 | </state> | |
| 2295 | ||
| 2296 | <postalCod e> | |
| 2297 | 35080 | |
| 2298 | </postalCo de> | |
| 2299 | ||
| 2300 | </addr> | |
| 2301 | ||
| 2302 | </represen tedOrganiz ation> | |
| 2303 | ||
| 2304 | </assigned Entity> | |
| 2305 | ||
| 2306 | </performe r> | |
| 2307 | ||
| 2308 | <participa nt | |
| 2309 | typeCode=" COV" | |
| 2310 | contextCon trolCode=" OP" | |
| 2311 | > | |
| 2312 | ||
| 2313 | <time> | |
| 2314 | ||
| 2315 | <low | |
| 2316 | nullFlavor ="NA" | |
| 2317 | /> | |
| 2318 | ||
| 2319 | <high | |
| 2320 | nullFlavor ="NA" | |
| 2321 | /> | |
| 2322 | ||
| 2323 | </time> | |
| 2324 | ||
| 2325 | <participa ntRole | |
| 2326 | classCode= "PAT" | |
| 2327 | > | |
| 2328 | ||
| 2329 | <id /> | |
| 2330 | ||
| 2331 | <code | |
| 2332 | nullFlavor ="NA" | |
| 2333 | > | |
| 2334 | ||
| 2335 | <originalT ext> | |
| 2336 | Unknown | |
| 2337 | </original Text> | |
| 2338 | ||
| 2339 | </code> | |
| 2340 | ||
| 2341 | <addr | |
| 2342 | nullFlavor ="NA" | |
| 2343 | /> | |
| 2344 | ||
| 2345 | <telecom | |
| 2346 | nullFlavor ="NA" | |
| 2347 | /> | |
| 2348 | ||
| 2349 | <playingEn tity | |
| 2350 | determiner Code="INST ANCE" | |
| 2351 | > | |
| 2352 | ||
| 2353 | <name> | |
| 2354 | ||
| 2355 | <given | |
| 2356 | nullFlavor ="NA" | |
| 2357 | /> | |
| 2358 | ||
| 2359 | <family> | |
| 2360 | NOT GIVEN | |
| 2361 | </family> | |
| 2362 | ||
| 2363 | </name> | |
| 2364 | ||
| 2365 | <birthTime | |
| 2366 | nullFlavor ="UNK" | |
| 2367 | xmlns="urn :hl7-org:s dtc" | |
| 2368 | /> | |
| 2369 | ||
| 2370 | <desc> | |
| 2371 | SUBSCRIBER | |
| 2372 | </desc> | |
| 2373 | ||
| 2374 | </playingE ntity> | |
| 2375 | ||
| 2376 | </particip antRole> | |
| 2377 | ||
| 2378 | </particip ant> | |
| 2379 | ||
| 2380 | <participa nt | |
| 2381 | typeCode=" HLD" | |
| 2382 | contextCon trolCode=" OP" | |
| 2383 | > | |
| 2384 | ||
| 2385 | <time> | |
| 2386 | ||
| 2387 | <low | |
| 2388 | nullFlavor ="NA" | |
| 2389 | /> | |
| 2390 | ||
| 2391 | <high | |
| 2392 | nullFlavor ="NA" | |
| 2393 | /> | |
| 2394 | ||
| 2395 | </time> | |
| 2396 | ||
| 2397 | <participa ntRole> | |
| 2398 | ||
| 2399 | <id | |
| 2400 | root="2.16 .840.1.113 883.4.6^14 17023904" | |
| 2401 | /> | |
| 2402 | ||
| 2403 | <addr | |
| 2404 | nullFlavor ="NA" | |
| 2405 | use="WP" | |
| 2406 | /> | |
| 2407 | ||
| 2408 | <telecom | |
| 2409 | nullFlavor ="NA" | |
| 2410 | /> | |
| 2411 | ||
| 2412 | <playingEn tity | |
| 2413 | determiner Code="INST ANCE" | |
| 2414 | > | |
| 2415 | ||
| 2416 | <name> | |
| 2417 | ||
| 2418 | <given | |
| 2419 | nullFlavor ="NA" | |
| 2420 | /> | |
| 2421 | ||
| 2422 | <family> | |
| 2423 | NOT GIVEN | |
| 2424 | </family> | |
| 2425 | ||
| 2426 | </name> | |
| 2427 | ||
| 2428 | <birthTime | |
| 2429 | nullFlavor ="UNK" | |
| 2430 | xmlns="urn :hl7-org:s dtc" | |
| 2431 | /> | |
| 2432 | ||
| 2433 | <desc> | |
| 2434 | SUBSCRIBER | |
| 2435 | </desc> | |
| 2436 | ||
| 2437 | </playingE ntity> | |
| 2438 | ||
| 2439 | </particip antRole> | |
| 2440 | ||
| 2441 | </particip ant> | |
| 2442 | ||
| 2443 | <entryRela tionship | |
| 2444 | typeCode=" REFR" | |
| 2445 | > | |
| 2446 | ||
| 2447 | <act | |
| 2448 | classCode= "ACT" | |
| 2449 | moodCode=" EVN" | |
| 2450 | > | |
| 2451 | ||
| 2452 | <templateI d | |
| 2453 | root="2.16 .840.1.113 883. IP " | |
| 2454 | /> | |
| 2455 | ||
| 2456 | <id /> | |
| 2457 | ||
| 2458 | <code | |
| 2459 | nullFlavor ="NA" | |
| 2460 | /> | |
| 2461 | ||
| 2462 | <entryRela tionship | |
| 2463 | typeCode=" SUBJ" | |
| 2464 | > | |
| 2465 | ||
| 2466 | <procedure | |
| 2467 | classCode= "PROC" | |
| 2468 | moodCode=" PRMS" | |
| 2469 | > | |
| 2470 | ||
| 2471 | <code | |
| 2472 | xsi:type=" CE" | |
| 2473 | code="D" | |
| 2474 | codeSystem ="2.16.840 .1.113883. 6.255.1336 " | |
| 2475 | codeSystem Name="X12N -1336" | |
| 2476 | displayNam e="Disabil ity" | |
| 2477 | /> | |
| 2478 | ||
| 2479 | </procedur e> | |
| 2480 | ||
| 2481 | </entryRel ationship> | |
| 2482 | ||
| 2483 | </act> | |
| 2484 | ||
| 2485 | </entryRel ationship> | |
| 2486 | ||
| 2487 | <entryRela tionship | |
| 2488 | typeCode=" REFR" | |
| 2489 | > | |
| 2490 | ||
| 2491 | <act | |
| 2492 | classCode= "ACT" | |
| 2493 | moodCode=" DEF" | |
| 2494 | > | |
| 2495 | ||
| 2496 | <id | |
| 2497 | root="2.16 .840.1.113 883.4.6^14 17023904" | |
| 2498 | /> | |
| 2499 | ||
| 2500 | <code | |
| 2501 | nullFlavor ="NA" | |
| 2502 | /> | |
| 2503 | ||
| 2504 | <text | |
| 2505 | nullFlavor ="NA" | |
| 2506 | /> | |
| 2507 | ||
| 2508 | </act> | |
| 2509 | ||
| 2510 | </entryRel ationship> | |
| 2511 | ||
| 2512 | </act> | |
| 2513 | ||
| 2514 | </entryRel ationship> | |
| 2515 | ||
| 2516 | <entryRela tionship | |
| 2517 | typeCode=" COMP" | |
| 2518 | > | |
| 2519 | ||
| 2520 | <sequenceN umber | |
| 2521 | value="3" | |
| 2522 | /> | |
| 2523 | ||
| 2524 | <act | |
| 2525 | classCode= "ACT" | |
| 2526 | moodCode=" EVN" | |
| 2527 | > | |
| 2528 | ||
| 2529 | <templateI d | |
| 2530 | root="2.16 .840.1.113 883. IP " | |
| 2531 | /> | |
| 2532 | ||
| 2533 | <templateI d | |
| 2534 | root="2.16 .840.1.113 883.3.88.1 1.83.5" | |
| 2535 | /> | |
| 2536 | ||
| 2537 | <templateI d | |
| 2538 | root="1.3. 6.1.4.1.19 376.1.5.3. 1.4.18" | |
| 2539 | /> | |
| 2540 | ||
| 2541 | <id | |
| 2542 | root="2.16 .840.1.113 883.4.6^14 17023904" | |
| 2543 | extension= "638433" | |
| 2544 | /> | |
| 2545 | ||
| 2546 | <code | |
| 2547 | code="PP" | |
| 2548 | codeSystem ="2.16.840 .1.113883. 6.255.1336 " | |
| 2549 | codeSystem Name="X12N -1336" | |
| 2550 | displayNam e="Persona l Payment" | |
| 2551 | /> | |
| 2552 | ||
| 2553 | <statusCod e | |
| 2554 | code="comp leted" | |
| 2555 | /> | |
| 2556 | ||
| 2557 | <performer | |
| 2558 | typeCode=" PRF" | |
| 2559 | > | |
| 2560 | ||
| 2561 | <time | |
| 2562 | nullFlavor ="NA" | |
| 2563 | /> | |
| 2564 | ||
| 2565 | <assignedE ntity | |
| 2566 | classCode= "ASSIGNED" | |
| 2567 | > | |
| 2568 | ||
| 2569 | <id | |
| 2570 | nullFlavor ="NA" | |
| 2571 | /> | |
| 2572 | ||
| 2573 | <code | |
| 2574 | code="GUAR " | |
| 2575 | codeSystem ="2.16.840 .1.113883. 5.110" | |
| 2576 | codeSystem Name="Role Class" | |
| 2577 | /> | |
| 2578 | ||
| 2579 | <addr | |
| 2580 | nullFlavor ="NA" | |
| 2581 | use="HP" | |
| 2582 | /> | |
| 2583 | ||
| 2584 | <telecom | |
| 2585 | nullFlavor ="NA" | |
| 2586 | /> | |
| 2587 | ||
| 2588 | <represent edOrganiza tion | |
| 2589 | classCode= "ORG" | |
| 2590 | determiner Code="INST ANCE" | |
| 2591 | > | |
| 2592 | ||
| 2593 | <name | |
| 2594 | nullFlavor ="NA" | |
| 2595 | /> | |
| 2596 | ||
| 2597 | <telecom | |
| 2598 | nullFlavor ="NA" | |
| 2599 | /> | |
| 2600 | ||
| 2601 | <addr | |
| 2602 | nullFlavor ="NA" | |
| 2603 | /> | |
| 2604 | ||
| 2605 | </represen tedOrganiz ation> | |
| 2606 | ||
| 2607 | </assigned Entity> | |
| 2608 | ||
| 2609 | </performe r> | |
| 2610 | ||
| 2611 | <participa nt | |
| 2612 | typeCode=" COV" | |
| 2613 | contextCon trolCode=" OP" | |
| 2614 | > | |
| 2615 | ||
| 2616 | <time> | |
| 2617 | ||
| 2618 | <low | |
| 2619 | nullFlavor ="NA" | |
| 2620 | /> | |
| 2621 | ||
| 2622 | <high | |
| 2623 | nullFlavor ="NA" | |
| 2624 | /> | |
| 2625 | ||
| 2626 | </time> | |
| 2627 | ||
| 2628 | <participa ntRole | |
| 2629 | classCode= "PAT" | |
| 2630 | > | |
| 2631 | ||
| 2632 | <id | |
| 2633 | root="2.16 .840.1.113 883.4.6^14 17023904" | |
| 2634 | extension= "638433" | |
| 2635 | /> | |
| 2636 | ||
| 2637 | <code | |
| 2638 | nullFlavor ="NA" | |
| 2639 | > | |
| 2640 | ||
| 2641 | <originalT ext> | |
| 2642 | Unknown | |
| 2643 | </original Text> | |
| 2644 | ||
| 2645 | </code> | |
| 2646 | ||
| 2647 | <addr | |
| 2648 | nullFlavor ="NA" | |
| 2649 | /> | |
| 2650 | ||
| 2651 | <telecom | |
| 2652 | nullFlavor ="NA" | |
| 2653 | /> | |
| 2654 | ||
| 2655 | <playingEn tity | |
| 2656 | determiner Code="INST ANCE" | |
| 2657 | > | |
| 2658 | ||
| 2659 | <name> | |
| 2660 | ||
| 2661 | <given | |
| 2662 | nullFlavor ="NA" | |
| 2663 | /> | |
| 2664 | ||
| 2665 | <family> | |
| 2666 | NOT GIVEN | |
| 2667 | </family> | |
| 2668 | ||
| 2669 | </name> | |
| 2670 | ||
| 2671 | <birthTime | |
| 2672 | nullFlavor ="UNK" | |
| 2673 | xmlns="urn :hl7-org:s dtc" | |
| 2674 | /> | |
| 2675 | ||
| 2676 | <desc> | |
| 2677 | UNK | |
| 2678 | </desc> | |
| 2679 | ||
| 2680 | </playingE ntity> | |
| 2681 | ||
| 2682 | </particip antRole> | |
| 2683 | ||
| 2684 | </particip ant> | |
| 2685 | ||
| 2686 | <entryRela tionship | |
| 2687 | typeCode=" REFR" | |
| 2688 | > | |
| 2689 | ||
| 2690 | <act | |
| 2691 | classCode= "ACT" | |
| 2692 | moodCode=" DEF" | |
| 2693 | > | |
| 2694 | ||
| 2695 | <id | |
| 2696 | nullFlavor ="NA" | |
| 2697 | /> | |
| 2698 | ||
| 2699 | <code | |
| 2700 | nullFlavor ="NA" | |
| 2701 | /> | |
| 2702 | ||
| 2703 | <text | |
| 2704 | nullFlavor ="NA" | |
| 2705 | /> | |
| 2706 | ||
| 2707 | </act> | |
| 2708 | ||
| 2709 | </entryRel ationship> | |
| 2710 | ||
| 2711 | </act> | |
| 2712 | ||
| 2713 | </entryRel ationship> | |
| 2714 | ||
| 2715 | </act> | |
| 2716 | ||
| 2717 | </entry> | |
| 2718 | ||
| 2719 | </section> | |
| 2720 | ||
| 2721 | </componen t> | |
| 2722 | ||
| 2723 | </structur edBody> | |
| 2724 | ||
| 2725 | </componen t> | |
| 2726 | </Clinical Document> |
Araxis Merge (but not the data content of this report) is Copyright © 1993-2016 Araxis Ltd (www.araxis.com). All rights reserved.