source: qrda/CCR/M1-QRDA/M1-PAT_100839_QRDA_V1_0_0Ver2.xml@ 1758

Last change on this file since 1758 was 1013, checked in by George Lilly, 14 years ago

some QRDA files, not final
File size: 38.4 KB
Line 
1<?xml version="1.0" encoding="utf-8"?>
2<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 CDA.xsd">
3 <realmCode code="US"/>
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9 <title>QRDA Incidence Report</title>
10 <effectiveTime value="20100703"/>
11 <confidentialityCode codeSystem="2.16.840.1.113883.5.25" code="N"/>
12 <languageCode code="en-US"/>
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15 <recordTarget>
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18 <addr use="H">
19 <streetAddressLine/>
20 <city/>
21 <state/>
22 <postalCode/>
23 </addr>
24 <telecom/>
25 <patient>
26 <name>
27 <given>JODY</given>
28 <given>JEAN</given>
29 <family>JONES</family>
30 </name>
31 <administrativeGenderCode displayName="FEMALE" code="F" codeSystemName="HL7 AdministrativeGender" codeSystem="2.16.840.1.113883.5.1"/>
32 <birthTime value="19450101120000"/>
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34<ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.5.50"/>
35</patient>
36 <providerOrganization>
37<!-- NPI for the provider and this is a real number-->
38 <id root="2.16.840.1.113883.4.6" extension="1558574525" />
39 <name>WorldVistA Test Clinic</name>
40 <!--WVV Address of organization is optional except for the STATE-->
41 <addr>
42 <state>MD</state>
43 <postalCode>20877</postalCode>
44
45 </addr>
46 <!--WVP required asOrganizationPartOf added to sample-->
47 <asOrganizationPartOf>
48 <wholeOrganization>
49 <!-- Tax ID is the extension and this is a dummy numbers-->
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53 </providerOrganization>
54
55 </patientRole>
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79 <name>World VistA Test Clinic</name>
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117 <family>Anthracite</family>
118 </name>
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135 <city>Gaithersburg</city>
136 <state>MD</state>
137 <postalCode>20877</postalCode>
138 </addr>
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161 <addr>
162 <streetAddressLine>123 Maple Ave</streetAddressLine>
163 <city>Gaithersburg</city>
164 <state>MD</state>
165 <postalCode>20877</postalCode>
166 </addr>
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168 <name>
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189 <addr>
190 <streetAddressLine>123 Maple Ave</streetAddressLine>
191 <city>Gaithersburg</city>
192 <state>MD</state>
193 <postalCode>20877</postalCode>
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219 <city>Gaithersburg</city>
220 <state>MD</state>
221 <postalCode>20877</postalCode>
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247 <city>Gaithersburg</city>
248 <state>MD</state>
249 <postalCode>20877</postalCode>
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273 <addr>
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275 <city>Gaithersburg</city>
276 <state>MD</state>
277 <postalCode>20877</postalCode>
278 </addr>
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303 <city>Gaithersburg</city>
304 <state>MD</state>
305 <postalCode>20877</postalCode>
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330 <streetAddressLine>123 Maple Ave</streetAddressLine>
331 <city>Gaithersburg</city>
332 <state>MD</state>
333 <postalCode>20877</postalCode>
334 </addr>
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356 <code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM CT" displayName="Internal Medician Specialist"/>
357 <addr>
358 <streetAddressLine>123 Maple Ave</streetAddressLine>
359 <city>Gaithersburg</city>
360 <state>MD</state>
361 <postalCode>20877</postalCode>
362 </addr>
363 <assignedPerson>
364 <name>
365 <given>Nancy</given>
366 <family>Anthracite</family>
367 <suffix>MD</suffix>
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378 <templateId root="2.16.840.1.113883.3.249.11.50"/>
379 <code code="55185-3" codeSystem="2.16.840.1.113883.6.1"/>
380 <title>Measure set: CMS EHR Measure Set</title>
381 <text>2010 Measures Set Measures</text>
382 <component>
383 <section>
384 <templateId root="2.16.840.1.113883.3.249.11.2"/>
385 <code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
386 <title>Measure Section</title>
387 <text>
388 <list>
389 <item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
390 </list>
391 </text>
392 <entry typeCode="DRIV">
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395 <code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
396 <text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
397 <statusCode code="completed"/>
398 </act>
399 </entry>
400 <component>
401 <section>
402 <code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
403 <title>Reporting Parameters</title>
404 <text>
405 <list>
406 <item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
407 </list>
408 </text>
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423 <title>Patient Data</title>
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444 <city>ALBANY</city>
445 <state>NY</state>
446 <postalCode>12180</postalCode>
447 </addr>
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449 <assignedPerson>
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452 <given>M</given>
453 <family>KING</family>
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492 <streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
493 <city>ALBANY</city>
494 <state>NY</state>
495 <postalCode>12180</postalCode>
496 </addr>
497 <telecom/>
498 <assignedPerson>
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500 <given>MATTHEW</given>
501 <given>M</given>
502 <family>KING</family>
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514 <effectiveTime>
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516 <high value="20101014"/>
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518 <value xsi:type="CD" displayName="ANY DEEP VEIN THROMBOSIS" code="453.8" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
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540 <addr use="WP">
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542 <city>ALBANY</city>
543 <state>NY</state>
544 <postalCode>12180</postalCode>
545 </addr>
546 <telecom/>
547 <assignedPerson>
548 <name>
549 <prefix>Scholar Extraordinaire</prefix>
550 <given>EIGHT</given>
551 <family>PROVIDER</family>
552 </name>
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562 <statusCode code="completed"/>
563 <effectiveTime>
564 <low value="20100904"/>
565 <high value="20100904"/>
566 </effectiveTime>
567 <value xsi:type="CD" displayName="Diabetes Mellitus without mention of Complication, type II or unspecified type," code="250.00" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
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