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<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">
   <realmCode code="US"/>
   <typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
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   <code code="55182-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Quality Measure Report"/>
   <title>QRDA Incidence Report</title>
   <effectiveTime value="20100703"/>
   <confidentialityCode codeSystem="2.16.840.1.113883.5.25" code="N"/>
   <languageCode code="en-US"/>
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         <addr use="H">
            <streetAddressLine/>
            <city/>
            <state/>
            <postalCode/>
         </addr>
         <telecom/>
         <patient>
            <name>
               <given>JODY</given>
               <given>JEAN</given>
               <family>JONES</family>
            </name>
            <administrativeGenderCode displayName="FEMALE" code="F" codeSystemName="HL7 AdministrativeGender" codeSystem=""/>
            <birthTime value="19450101120000"/>
         </patient>
      </patientRole>
   </recordTarget>
   <author>
      <time value="20100703"/>
      <assignedAuthor>
         <id root="2.16.840.1.113883.3.249.6" extension="100001"/>
         <assignedPerson>
            <name>
               <given>Nancy</given>
               <family>Anthracite</family>
               <suffix>MD</suffix>
            </name>
         </assignedPerson>
         <representedOrganization>
            <id root="2.16.840.1.113883.3.543" extension="1558574526"/>
            <name>WorldVistA Test Clinic</name>
         </representedOrganization>
      </assignedAuthor>
   </author>
   <informant>
      <assignedEntity>
         <id nullFlavor="NA"/>
         <representedOrganization>
            <id root="2.16.840.1.113883.3.543" extension="1558574526"/>
            <name>World VistA Test Clinic</name>
         </representedOrganization>
      </assignedEntity>
   </informant>
   <custodian>
      <assignedCustodian>
         <representedCustodianOrganization>
            <id root="2.16.840.1.113883.3.543" extension="1558574526"/>
            <name>WorldVistA Test Clinic</name>
         </representedCustodianOrganization>
      </assignedCustodian>
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   <legalAuthenticator>
      <time value="20100703"/>
      <signatureCode code="S"/>
      <assignedEntity>
         <id root="2.16.840.1.113883.3.543" extension="111111"/>
         <assignedPerson>
            <name>
               <given>Nancy</given>
               <family>Anthracite</family>
               <suffix>MD</suffix>
            </name>
         </assignedPerson>
         <representedOrganization>
            <id root="2.16.840.1.113883.3.543" extension="1558574526"/>
            <name>WorldVistA Test Clinic</name>
         </representedOrganization>
      </assignedEntity>
   </legalAuthenticator>
   <participant typeCode="PRF">
      <functionCode code="PCP" codeSystem="2.16.840.1.113883.5.88"/>
      <associatedEntity classCode="PROV">
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         <associatedPerson>
            <name>
               <prefix>Dr.</prefix>
               <given>Nancy</given>
               <family>Anthracite</family>
            </name>
         </associatedPerson>
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   <component>
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               <templateId root="2.16.840.1.113883.3.249.11.50"/>
               <code code="55185-3" codeSystem="2.16.840.1.113883.6.1"/>
               <title>Measure set: CMS EHR Measure Set</title>
               <text>2010 Measures Set Measures</text>
               <component>
                  <section>
                     <templateId root="2.16.840.1.113883.3.249.11.2"/>
                     <code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
                     <title>Measure Section</title>
                     <text>
                        <list>
                           <item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
                        </list>
                     </text>
                     <entry typeCode="DRIV">
                        <act classCode="ACT" moodCode="DEF">
                           <id root="2.16.840.1.113883.3.249.11.2"/>
                           <code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
                           <text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
                           <statusCode code="completed"/>
                        </act>
                     </entry>
                     <component>
                        <section>
                           <code code="55187-9" codeSystem="2.16.840.1.113883.6.1"/>
                           <title>Reporting Parameters</title>
                           <text>
                              <list>
                                 <item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
                              </list>
                           </text>
                           <entry>
                              <act classCode="ACT" moodCode="EVN">
                                 <code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
                                 <effectiveTime>
                                    <low value="20100101"/>
                                    <high value="20101231"/>
                                 </effectiveTime>
                              </act>
                           </entry>
                        </section>
                     </component>
                     <component>
                        <section>
                           <code code="55188-7" codeSystem="2.16.840.1.113883.6.1"/>
                           <title>Patient Data</title>
                        </section>
                     </component>
                     <component>
                        <section>
                           <templateId root="2.16.840.1.113883.10.20.1.12"/>
                           <code code="47519-4" codeSystem="2.16.840.1.113883.6.1"/>
                           <title>Procedures</title>
                           <text>
                              <table>
                                 <tbody>
                                    <tr>
                                       <th>Type</th>
                                       <th>Date</th>
                                       <th>Code</th>
                                       <th>Description</th>
                                       <th>Location</th>
                                       <th>Substance</th>
                                       <th>Method</th>
                                       <th>Position</th>
                                       <th>Site</th>
                                       <th>Status</th>
                                       <th>Source</th>
                                    </tr>
                                    <tr id="PROCEDURE_4056_27">
                                       <td/>
                                       <table>
                                          <tbody>
                                             <tr xmlns="">
                                                <td>Procedure Date:
          </td>
                                                <td>Sep 04, 2010</td>
                                             </tr>
                                          </tbody>
                                       </table>
                                       <td>99213 (CPT-4)
		</td>
                                       <td>INTERMEDIATE (15min)</td>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td>Completed</td>
                                       <td>SYSTEM  MANAGER   </td>
                                    </tr>
                                    <tr id="PROCEDURE_4055_24">
                                       <td/>
                                       <table>
                                          <tbody>
                                             <tr xmlns="">
                                                <td>Procedure Date:
          </td>
                                                <td>Aug 28, 2010</td>
                                             </tr>
                                          </tbody>
                                       </table>
                                       <td>99202 (CPT-4)
		</td>
                                       <td>EXPANDED, HX &amp; EXAM</td>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td>Completed</td>
                                       <td>SYSTEM  MANAGER   </td>
                                    </tr>
                                    <tr id="PROCEDURE_4047_14">
                                       <td/>
                                       <table>
                                          <tbody>
                                             <tr xmlns="">
                                                <td>Procedure Date:
          </td>
                                                <td>Jul 31, 2010</td>
                                             </tr>
                                          </tbody>
                                       </table>
                                       <td>99213 (CPT-4)
		</td>
                                       <td>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)</td>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td>Completed</td>
                                       <td>SYSTEM  MANAGER   </td>
                                    </tr>
                                    <tr id="PROCEDURE_4046_7">
                                       <td/>
                                       <table>
                                          <tbody>
                                             <tr xmlns="">
                                                <td>Procedure Date:
          </td>
                                                <td>Jul 05, 2010</td>
                                             </tr>
                                          </tbody>
                                       </table>
                                       <td>99214 (CPT-4)
		</td>
                                       <td>Office/Outpatient Visit of an Established Patient requiring (2 of 3) a Detailed History, an Exam and Medical Decision Making of Moderate Complexity (CPT-4 99214)</td>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td>Completed</td>
                                       <td>EIGHT  PROVIDER  Scholar Extraordinaire </td>
                                    </tr>
                                    <tr id="PROCEDURE_4046_8">
                                       <td/>
                                       <table>
                                          <tbody>
                                             <tr xmlns="">
                                                <td>Procedure Date:
          </td>
                                                <td>Jul 05, 2010</td>
                                             </tr>
                                          </tbody>
                                       </table>
                                       <td>83036 (CPT-4)
		</td>
                                       <td>Hemoglobin; Glycosylated (A1c) (CPT-4 83036)</td>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td>Completed</td>
                                       <td>EIGHT  PROVIDER  Scholar Extraordinaire </td>
                                    </tr>
                                    <tr id="PROCEDURE_4046_9">
                                       <td/>
                                       <table>
                                          <tbody>
                                             <tr xmlns="">
                                                <td>Procedure Date:
          </td>
                                                <td>Jul 05, 2010</td>
                                             </tr>
                                          </tbody>
                                       </table>
                                       <td>83704 (CPT-4)
		</td>
                                       <td>Lipoprotein, Blood; Quantitation of Lipoprotein particle Numbers and Lipoprotein particle Subclasses (Eg, by Nuclear Magnetic Resonance Spectroscopy) (CPT-4 83704)</td>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td>Completed</td>
                                       <td>EIGHT  PROVIDER  Scholar Extraordinaire </td>
                                    </tr>
                                    <tr id="PROCEDURE_4046_10">
                                       <td/>
                                       <table>
                                          <tbody>
                                             <tr xmlns="">
                                                <td>Procedure Date:
          </td>
                                                <td>Jul 05, 2010</td>
                                             </tr>
                                          </tbody>
                                       </table>
                                       <td>78414 (CPT-4)
		</td>
                                       <td>Determination of Central C-V Hemodynamics (Non-Imaging) (CPT-4 78414)</td>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td/>
                                       <td>Completed</td>
                                       <td>EIGHT  PROVIDER  Scholar Extraordinaire </td>
                                    </tr>
                                 </tbody>
                              </table>
                           </text>
                           <entry typeCode="DRIV">
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                                 <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD"/>
                                 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC"/>
                                 <id root="PROCEDURE_4056_27" extension="CCRObjectID"/>
                                 <code displayName="INTERMEDIATE (15min)" code="99213" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
                                 <text>
                                    <reference value="#PROCEDURE_4056_27"/>
                                 </text>
                                 <statusCode code="completed"/>
                                 <effectiveTime>
                                    <low value="20100904"/>
                                    <high nullFlavor="UNK"/>
                                 </effectiveTime>
                              </procedure>
                           </entry>
                           <entry typeCode="DRIV">
                              <procedure classCode="PROC" moodCode="EVN">
                                 <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP C83"/>
                                 <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD"/>
                                 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC"/>
                                 <id root="PROCEDURE_4055_24" extension="CCRObjectID"/>
                                 <code displayName="EXPANDED, HX &amp; EXAM" code="99202" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
                                 <text>
                                    <reference value="#PROCEDURE_4055_24"/>
                                 </text>
                                 <statusCode code="completed"/>
                                 <effectiveTime>
                                    <low value="20100828"/>
                                    <high nullFlavor="UNK"/>
                                 </effectiveTime>
                              </procedure>
                           </entry>
                           <entry typeCode="DRIV">
                              <procedure classCode="PROC" moodCode="EVN">
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                                 <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD"/>
                                 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC"/>
                                 <id root="PROCEDURE_4047_14" extension="CCRObjectID"/>
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                                 <text>
                                    <reference value="#PROCEDURE_4047_14"/>
                                 </text>
                                 <statusCode code="completed"/>
                                 <effectiveTime>
                                    <low value="20100731"/>
                                    <high nullFlavor="UNK"/>
                                 </effectiveTime>
                              </procedure>
                           </entry>
                           <entry typeCode="DRIV">
                              <procedure classCode="PROC" moodCode="EVN">
                                 <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP C83"/>
                                 <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD"/>
                                 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC"/>
                                 <id root="PROCEDURE_4046_7" extension="CCRObjectID"/>
                                 <code displayName="Office/Outpatient Visit of an Established Patient requiring (2 of 3) a Detailed History, an Exam and Medical Decision Making of Moderate Complexity (CPT-4 99214)" code="99214" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
                                 <text>
                                    <reference value="#PROCEDURE_4046_7"/>
                                 </text>
                                 <statusCode code="completed"/>
                                 <effectiveTime>
                                    <low value="20100705"/>
                                    <high nullFlavor="UNK"/>
                                 </effectiveTime>
                              </procedure>
                           </entry>
                           <entry typeCode="DRIV">
                              <procedure classCode="PROC" moodCode="EVN">
                                 <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP C83"/>
                                 <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD"/>
                                 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC"/>
                                 <id root="PROCEDURE_4046_8" extension="CCRObjectID"/>
                                 <code displayName="Hemoglobin; Glycosylated (A1c) (CPT-4 83036)" code="83036" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
                                 <text>
                                    <reference value="#PROCEDURE_4046_8"/>
                                 </text>
                                 <statusCode code="completed"/>
                                 <effectiveTime>
                                    <low value="20100705"/>
                                    <high nullFlavor="UNK"/>
                                 </effectiveTime>
                              </procedure>
                           </entry>
                           <entry typeCode="DRIV">
                              <procedure classCode="PROC" moodCode="EVN">
                                 <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP C83"/>
                                 <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD"/>
                                 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC"/>
                                 <id root="PROCEDURE_4046_9" extension="CCRObjectID"/>
                                 <code displayName="Lipoprotein, Blood; Quantitation of Lipoprotein particle Numbers and Lipoprotein particle Subclasses (Eg, by Nuclear Magnetic Resonance Spectroscopy) (CPT-4 83704)" code="83704" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
                                 <text>
                                    <reference value="#PROCEDURE_4046_9"/>
                                 </text>
                                 <statusCode code="completed"/>
                                 <effectiveTime>
                                    <low value="20100705"/>
                                    <high nullFlavor="UNK"/>
                                 </effectiveTime>
                              </procedure>
                           </entry>
                           <entry typeCode="DRIV">
                              <procedure classCode="PROC" moodCode="EVN">
                                 <templateId root="2.16.840.1.113883.3.88.11.83.17" assigningAuthorityName="HITSP C83"/>
                                 <templateId root="2.16.840.1.113883.10.20.1.29" assigningAuthorityName="CCD"/>
                                 <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.19" assigningAuthorityName="IHE PCC"/>
                                 <id root="PROCEDURE_4046_10" extension="CCRObjectID"/>
                                 <code displayName="Determination of Central C-V Hemodynamics (Non-Imaging) (CPT-4 78414)" code="78414" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
                                 <text>
                                    <reference value="#PROCEDURE_4046_10"/>
                                 </text>
                                 <statusCode code="completed"/>
                                 <effectiveTime>
                                    <low value="20100705"/>
                                    <high nullFlavor="UNK"/>
                                 </effectiveTime>
                              </procedure>
                           </entry>
                        </section>
                     </component>
                     <component>
                        <section>
                           <templateId root="2.16.840.1.113883.10.20.1.9"/>
                           <code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
                           <title>Payers</title>
                           <text/>
                           <entry typeCode="DRIV">
                              <act classCode="ACT" moodCode="DEF">
                                 <templateId root="2.16.840.1.113883.10.20.1.20"/>
                                 <id root="2.16.840.1.113883.3.543" extension="@@@UUID-PAYER@@@"/>
                                 <code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
                                 <statusCode code="completed"/>
                                 <entryRelationship typeCode="COMP">
                                    <act classCode="ACT" moodCode="EVN">
                                       <templateId root="2.16.840.1.113883.10.20.1.26"/>
                                       <templateId root="2.16.840.1.113883.3.249.11.100.7"/>
                                       <id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/>
                                       <code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
                                       <statusCode code="completed"/>
                                       <performer typeCode="PRF">
                                          <assignedEntity>
                                             <id root="2.16.840.1.113883.12.86" extension="MC"/>
                                          </assignedEntity>
                                       </performer>
                                       <participant typeCode="COV">
                                          <participantRole>
                                             <id root="2.16.840.1.113883.4.1" extension="@@SSN@@"/>
                                             <code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
                                          </participantRole>
                                       </participant>
                                    </act>
                                 </entryRelationship>
                              </act>
                           </entry>
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</ClinicalDocument>