12344321 documentTitle_value authorPerson_value authorInstitution_value authorRole_value authorSpecialty_value availablityStatus_value classCode_value classCodeScheme_value classCodeDisplayName_value confidentialityCode_value confidentialityCodeScheme_value confidentialityCodeDisplayName_value 01/01/2000.11:59:59 formatCode_value formatCodeScheme_value formatCodeDisplayName_value patientId_value 02/02/2001.01:01:01 03/03/2002.02:02:02 status_value comments_value hash_value facilityCode_value facilityCodeScheme_value facilityCodeDisplayName_value intendedRecipientPerson_value intendedRecipientOrganization_value languageCode_value legalAuthenticator_value mimeType_value parentDocumentId_value parentDocumentRelationship_value practiceSetting_value practiceSettingScheme_value practiceSettingDisplayName_value 1234 sourcePatientId_value pid3_value pid5_value pid8_value pid7_value pid11_value typeCode_value typeCodeScheme_value typeCodeDisplayName_value documentUri_value Katy Bradford 437 TURNER LANE LEESBURG VA 20176 US MRS. KATY BRADFORD AdministrativeGender codes are: M (Male), F (Female) or UN (Undifferentiated). 439 TURNER LANE LEESBURG VA 20176 US MS. TERRY SHAW PHD PCP 10300 MAIN ST. SUITE 100 ASHBURN VA 20176 AF DR. JANE WATSON MD Doctors Inc.
Conditions or Problems
Problem Name Problem Type Problem Date
Sprained ankle Diagnosis 20080401
Migraines Problem 20080421
Allergies, Adverse Reactions, Alerts
Substance Event Type Severity
Trucare Drug Allergy Mild
peanuts Food Allergy Severe
Trucare peanuts
Insurance Providers
Insurance Provider Name Insurance Provider Type Insurance Provider Group Number
AJAX INSURANCE AJAX INSURANCE G1854093
AJAX INSURANCE
Medications
Product Display Name Free Text Brand Name Ordered Value Ordered Unit Expiration Time
Hyaline Hyalinia 30.0 TAB 20080430
Hyaline Hyalinia
Advance Directive Blood transfusion OK 9435 BELL ROAD 2ND FLOOR LEESBURG VA 20155 US MR FRED SMITH ESQ
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