| 1 | <?xml version="1.0" encoding="UTF-8"?>
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| 2 | <?xml-stylesheet type="text/xsl" href="ccr.xsl"?>
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| 3 | <ContinuityOfCareRecord xmlns="urn:astm-org:CCR">
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| 4 | <CCRDocumentObjectID>de7c3d33-e0e4-4e0d-9e2c-5dd3d8b831ab</CCRDocumentObjectID>
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| 5 | <Language>
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| 6 | <Text>English</Text>
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| 7 | </Language>
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| 8 | <Version>V1.0</Version>
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| 9 | <DateTime>
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| 10 | <ExactDateTime>2010-09-08T19:47:27-05:00</ExactDateTime>
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| 11 | </DateTime>
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| 12 | <Patient>
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| 13 | <ActorID>ACTORPATIENT_100662</ActorID>
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| 14 | </Patient>
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| 15 | <From>
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| 16 | <ActorLink>
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| 17 | <ActorID>ACTORPROVIDER_10000000020</ActorID>
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| 18 | </ActorLink>
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| 19 | <ActorLink>
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| 20 | <ActorID>ACTORSYSTEM_1</ActorID>
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| 21 | </ActorLink>
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| 22 | </From>
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| 23 | <To>
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| 24 | <ActorLink>
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| 25 | <ActorID>ACTORPATIENT_100662</ActorID>
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| 26 | <ActorRole>
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| 27 | <Text>Patient</Text>
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| 28 | </ActorRole>
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| 29 | </ActorLink>
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| 30 | </To>
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| 31 | <Purpose>
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| 32 | <Description>
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| 33 | <Text>CEND PHR</Text>
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| 34 | </Description>
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| 35 | </Purpose>
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| 36 | <Body>
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| 37 | <Problems>
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| 38 | <Problem>
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| 39 | <CCRDataObjectID>PROBLEM1</CCRDataObjectID>
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| 40 | <DateTime>
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| 41 | <ExactDateTime>2010-09-05T00:00:00-05:00</ExactDateTime>
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| 42 | </DateTime>
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| 43 | <Type>
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| 44 | <Text>Problem</Text>
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| 45 | </Type>
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| 46 | <Description>
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| 47 | <Text>Diabetes Mellitus without mention of Complication, type II or unspecified type,</Text>
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| 48 | <Code>
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| 49 | <Value>250.00</Value>
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| 50 | <CodingSystem>ICD9CM</CodingSystem>
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| 51 | </Code>
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| 52 | </Description>
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| 53 | <Status>
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| 54 | <Text>Active</Text>
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| 55 | </Status>
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| 56 | <Source>
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| 57 | <Actor>
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| 58 | <ActorID>ACTORPROVIDER_10000000020</ActorID>
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| 59 | </Actor>
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| 60 | </Source>
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| 61 | </Problem>
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| 62 | </Problems>
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| 63 | <Procedures>
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| 64 | <Procedure>
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| 65 | <CCRDataObjectID>PROCEDURE_4060_4</CCRDataObjectID>
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| 66 | <DateTime>
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| 67 | <Type>
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| 68 | <Text>Procedure Date</Text>
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| 69 | </Type>
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| 70 | <ExactDateTime>2010-09-05T00:00:00-05:00</ExactDateTime>
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| 71 | </DateTime>
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| 72 | <Description>
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| 73 | <Text>Office/Outpatient Visit of an Established Patient requiring (2 of 3) an Expanded History, an Exam and Medical Decision Making of Low Complexity (CPT-4 99213)</Text>
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| 74 | <Code>
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| 75 | <Value>99213</Value>
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| 76 | <CodingSystem>CPT-4</CodingSystem>
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| 77 | </Code>
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| 78 | </Description>
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| 79 | <Status>
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| 80 | <Text>Completed</Text>
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| 81 | </Status>
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| 82 | <Source>
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| 83 | <Actor>
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| 84 | <ActorID>ACTORPROVIDER_10000000020</ActorID>
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| 85 | </Actor>
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| 86 | </Source>
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| 87 | </Procedure>
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| 88 | </Procedures>
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| 89 | <Encounters>
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| 90 | <Encounter>
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| 91 | <CCRDataObjectID>ENCOUNTER_4060</CCRDataObjectID>
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| 92 | <DateTime>
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| 93 | <ExactDateTime>2010-09-05T00:00:00-05:00</ExactDateTime>
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| 94 | </DateTime>
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| 95 | <Type>
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| 96 | <Text> Office/Outpatient Visit of an Established Patient requiring (2 of 3) an Expanded History, an Exam and Medical Decision Making of Low Complexity (CPT-4 99213)</Text>
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| 97 | <Code>
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| 98 | <Value>99213</Value>
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| 99 | <CodingSystem>CPT-4</CodingSystem>
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| 100 | </Code>
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| 101 | </Type>
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| 102 | <Description>
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| 103 | <Text> Office/Outpatient Visit of an Established Patient requiring (2 of 3) an Expanded History, an Exam and Medical Decision Making of Low Complexity (CPT-4 99213)</Text>
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| 104 | <Code>
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| 105 | <Value>99213</Value>
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| 106 | <CodingSystem>CPT-4</CodingSystem>
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| 107 | </Code>
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| 108 | </Description>
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| 109 | <Location>
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| 110 | <Actor>
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| 111 | <ActorID>ACTORORGANIZATION_1</ActorID>
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| 112 | </Actor>
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| 113 | </Location>
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| 114 | <Practioner>
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| 115 | <Actor>
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| 116 | <ActorID>ACTORPROVIDER_10000000020</ActorID>
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| 117 | </Actor>
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| 118 | </Practioner>
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| 119 | <Source>
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| 120 | <Actor>
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| 121 | <ActorID>ACTORPROVIDER_10000000020</ActorID>
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| 122 | </Actor>
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| 123 | </Source>
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| 124 | <CommentID>NOTE_4060</CommentID>
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| 125 | </Encounter>
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| 126 | </Encounters>
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| 127 | </Body>
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| 128 | <Actors>
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| 129 | <Actor>
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| 130 | <ActorObjectID>ACTORORGANIZATION_1</ActorObjectID>
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| 131 | <Organization>
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| 132 | <Name>CAMP MASTER</Name>
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| 133 | </Organization>
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| 134 | <Address>
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| 135 | <Type>
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| 136 | <Text>Office</Text>
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| 137 | </Type>
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| 138 | <Line1>VA MEDICAL CENTER</Line1>
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| 139 | <City>ALBANY</City>
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| 140 | <State>NEW YORK</State>
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| 141 | <PostalCode>12180-0097</PostalCode>
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| 142 | </Address>
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| 143 | <Source>
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| 144 | <Actor>
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| 145 | <ActorID>ACTORSYSTEM_1</ActorID>
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| 146 | </Actor>
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| 147 | </Source>
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| 148 | </Actor>
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| 149 | <Actor>
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| 150 | <ActorObjectID>ACTORPATIENT_100662</ActorObjectID>
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| 151 | <Person>
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| 152 | <Name>
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| 153 | <CurrentName>
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| 154 | <Given>OUTPATIENT</Given>
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| 155 | <Family>FIFTYFIVE</Family>
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| 156 | </CurrentName>
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| 157 | </Name>
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| 158 | <DateOfBirth>
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| 159 | <ExactDateTime>1945-03-09</ExactDateTime>
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| 160 | </DateOfBirth>
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| 161 | <Gender>
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| 162 | <Text>MALE</Text>
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| 163 | <Code>
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| 164 | <Value>M</Value>
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| 165 | <CodingSystem>HL7 AdministrativeGender</CodingSystem>
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| 166 | </Code>
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| 167 | </Gender>
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| 168 | </Person>
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| 169 | <IDs>
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| 170 | <Type>
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| 171 | <Text>SSN</Text>
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| 172 | </Type>
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| 173 | <ID>666000655</ID>
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| 174 | <Source>
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| 175 | <Actor>
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| 176 | <ActorID>ACTORPATIENT_100662</ActorID>
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| 177 | </Actor>
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| 178 | </Source>
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| 179 | </IDs>
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| 180 | <Address>
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| 181 | <Type>
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| 182 | <Text>Home</Text>
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| 183 | </Type>
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| 184 | <Line1>Any Street</Line1>
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| 185 | <City>Any Town</City>
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| 186 | </Address>
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| 187 | <Source>
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| 188 | <Actor>
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| 189 | <ActorID>ACTORPATIENT_100662</ActorID>
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| 190 | </Actor>
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| 191 | </Source>
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| 192 | </Actor>
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| 193 | <Actor>
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| 194 | <ActorObjectID>ACTORPROVIDER_10000000020</ActorObjectID>
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| 195 | <Person>
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| 196 | <Name>
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| 197 | <CurrentName>
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| 198 | <Given>SYSTEM</Given>
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| 199 | <Family>MANAGER</Family>
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| 200 | </CurrentName>
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| 201 | </Name>
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| 202 | </Person>
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| 203 | <Specialty>
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| 204 | <Text>Physicians (M.D. and D.O.)-Physician/Osteopath</Text>
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| 205 | </Specialty>
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| 206 | <Address>
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| 207 | <Type>
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| 208 | <Text>Work</Text>
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| 209 | </Type>
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| 210 | <Line1>VA MEDICAL CENTER</Line1>
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| 211 | <City>ALBANY</City>
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| 212 | <State>NY</State>
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| 213 | <PostalCode>12180-0097</PostalCode>
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| 214 | </Address>
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| 215 | <Source>
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| 216 | <Actor>
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| 217 | <ActorID>ACTORSYSTEM_1</ActorID>
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| 218 | </Actor>
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| 219 | </Source>
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| 220 | <InternalCCRLink>
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| 221 | <LinkID>ACTORORGANIZATION_1</LinkID>
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| 222 | <LinkRelationship>representedOrganization</LinkRelationship>
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| 223 | </InternalCCRLink>
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| 224 | </Actor>
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| 225 | <Actor>
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| 226 | <ActorObjectID>ACTORSYSTEM_1</ActorObjectID>
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| 227 | <InformationSystem>
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| 228 | <Name>WorldVistA EHR/VOE</Name>
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| 229 | <Version>1.0</Version>
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| 230 | </InformationSystem>
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| 231 | <Source>
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| 232 | <Actor>
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| 233 | <ActorID>ACTORSYSTEM_1</ActorID>
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| 234 | </Actor>
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| 235 | </Source>
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| 236 | </Actor>
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| 237 | </Actors>
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| 238 | <Comments>
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| 239 | <Comment>
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| 240 | <CommentObjectID>@@COMMENTOBJECTID@@</CommentObjectID>
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| 241 | <DateTime>
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| 242 | <ExactDateTime>@@CMTDATETIME@@</ExactDateTime>
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| 243 | </DateTime>
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| 244 | <Source>
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| 245 | <Actor>
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| 246 | <ActorID>@@ACTORSOURCEID@@</ActorID>
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| 247 | </Actor>
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| 248 | </Source>
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| 249 | </Comment>
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| 250 | <Comment>
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| 251 | <CommentObjectID>NOTE_4060</CommentObjectID>
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| 252 | <DateTime>
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| 253 | <ExactDateTime>2010-09-05T00:00:00-05:00</ExactDateTime>
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| 254 | </DateTime>
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| 255 | <Description>
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| 256 | <Text>
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| 257 | DIABETIC TEST
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| 258 | PATIENT HBA1C RESULTS
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| 259 | PATIENTS HBA1C IS GREATER THAN 9%
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| 260 | HBA1C VALUE: 10.1
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| 261 | </Text>
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| 262 | </Description>
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| 263 | <Source>
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| 264 | <Actor>
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| 265 | <ActorID>ACTORPROVIDER_10000000020</ActorID>
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| 266 | </Actor>
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| 267 | </Source>
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| 268 | </Comment>
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| 269 | </Comments>
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| 270 | </ContinuityOfCareRecord>
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