bluebutton
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BlueButton.js helps developers navigate complex health data with ease.
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text/xml
<?xml version="1.0" encoding="UTF-8"?>
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:voc="urn:hl7-org:v3/voc" xmlns="urn:hl7-org:v3">
<realmCode code="US"/>
<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1"/>
<templateId root="2.16.840.1.113883.10.20.22.1.2"/>
<id root="2.16.840.1.113883.3.3297" extension="1.1.1.6.999.." />
<code code="34133-9" displayName="Summarization of episode note" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<title>Kinsights CCDA</title>
<effectiveTime value="-08"/>
<confidentialityCode code="N" displayName="Normal" codeSystem="2.16.840.1.113883.5.25" codeSystemName="Confidentiality"/>
<languageCode code="en-US"/>
<recordTarget typeCode="RCT" contextControlCode="OP">
<patientRole classCode="PAT">
<id root="2.16.840.1.113883.3.3297.1.1.1" extension="6"/>
<telecom value="tel:703-373-1575" use="HP"/>
<telecom value="tel:207-841-9103" use="WP"/>
<patient classCode="PSN" determinerCode="INSTANCE">
<name>
<given>Timmy</given>
<family>Wilkinson</family>
</name>
<administrativeGenderCode code="M" displayName="Male" codeSystem="2.16.840.1.113883.5.1" codeSystemName="Administrative Gender Code"/>
<birthTime value="20110401"/>
<maritalStatusCode code="S" displayName="Never Married" codeSystem="2.16.840.1.113883.5.2" codeSystemName="HL7v3 Marital Status Value Set"/>
<guardian>
<code code="PRN" displayName="Parent" codeSystem="2.16.840.1.113883.5.111" codeSystemName="HL7 Role code"/>
<addr use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>119 Grattan St</streetAddressLine>
<city>San Francisco</city>
<state>CA</state>
<postalCode>94117</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</addr>
<telecom value="207-841-9103" use="WP"/>
<telecom value="703-373-1575" use="HP"/>
<guardianPerson>
<name>
<given>Jackson</given>
<family>Wilkinson</family>
</name>
<telecom use="HP" value="tel:207-841-9103"/>
</guardianPerson>
</guardian>
<languageCommunication>
<languageCode code="eng"/>
</languageCommunication>
</patient>
<providerOrganization classCode="ORG" determinerCode="INSTANCE">
<name>Dr. David Yoon</name>
<telecom use="WP" value="tel:215-343-1212"/>
<telecom use='MP' value="tel:215-343-1213"/>
</providerOrganization>
</patientRole>
</recordTarget>
<author typeCode="AUT" contextControlCode="OP">
<time value="-08" />
<assignedAuthor classCode="ASSIGNED">
<id root='2.16.840.1.113883.4.6' nullFlavor='NA'/>
<addr>
<streetAddressLine>119 Grattan St</streetAddressLine>
<city>San Francisco</city>
<state>CA</state>
<postalCode>94117</postalCode>
<country>US</country>
</addr>
<telecom value="703-373-1575" use="HP"/>
<telecom value="207-841-9103" use="WP"/>
<assignedPerson classCode="PSN" determinerCode="INSTANCE">
<name>
<given>Jackson</given>
<family>Wilkinson</family>
</name>
</assignedPerson>
<assignedAuthoringDevice>
<manufacturerModelName>Kinsights</manufacturerModelName>
<softwareName>Kinsights Record Export</softwareName>
</assignedAuthoringDevice>
</assignedAuthor>
</author>
<custodian typeCode="CST">
<assignedCustodian classCode="ASSIGNED">
<representedCustodianOrganization classCode="ORG" determinerCode="INSTANCE">
<id nullFlavor="NA" />
<name>Kinsights</name>
<telecom use="WP" value="888.773.5303"/>
<addr>
<streetAddressLine>119 Grattan St</streetAddressLine>
<streetAddressLine nullFlavor="UNK"/>
<city>San Francisco</city>
<state>CA</state>
<postalCode>94117</postalCode>
<country>United States</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<documentationOf typeCode="DOC">
<serviceEvent classCode="PCPR" moodCode="EVN">
<effectiveTime nullFlavor="UNK">
<low nullFlavor="UNK"/>
<high nullFlavor="UNK"/>
</effectiveTime>
<performer typeCode="PRF">
<templateId root="2.16.840.1.113883.3.88.11.83.4"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.3"/>
<functionCode code="PP" displayName="Primary Care Provider" codeSystem="2.16.840.1.113883.12.443" codeSystemName="Provider Role"/>
<time nullFlavor="UNK">
<low nullFlavor="UNK"/>
<high nullFlavor="UNK"/>
</time>
<assignedEntity>
<id root="2.16.840.1.113883.4.6" extension="UNK"/>
<addr nullFlavor="UNK"/>
<telecom use="WP" nullFlavor="UNK"/>
<assignedPerson classCode="PSN" determinerCode="INSTANCE">
<name nullFlavor="UNK"/>
</assignedPerson>
</assignedEntity>
</performer>
<performer typeCode="PRF">
<templateId root="2.16.840.1.113883.3.88.11.83.4"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.3"/>
<assignedEntity>
<code code="-1" displayName="PCP" codeSystemName="GMTDynamic"/>
<assignedPerson classCode="PSN" determinerCode="INSTANCE">
<name>
Dr. David Yoon
</name>
</assignedPerson>
<telecom use="WP" value="tel:215-343-1212"/>
<telecom use='MP' value="tel:215-343-1213"/>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>
<component>
<structuredBody classCode="DOCBODY" moodCode="EVN">
<templateId root="2.16.840.1.113883.10" extension="MPL_CDAR2_LEVEL1-2REF_US_I2_2005SEP"/>
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
<!-- Allergies (entries required) section template -->
<code code="48765-2" codeSystem="2.16.840.1.113883.6.1"/>
<title>Allergies & Adverse Reactions</title>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="EVN">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.11" extension='2' />
<code code="48765-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Allergies, adverse reactions, alerts"/>
<statusCode code="active"/>
<effectiveTime>
<low value="20130701"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<id root="4a51d40f-db9f-414a-b7cf-d3c40c00835a"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<effectiveTime>
<low nullFlavor="UNK"/>
</effectiveTime>
<value xsi:type="CD" code="419199007" displayName="allergy to substance" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"></value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<code code="1564HD0N96" displayName="cat hair" codeSystem="2.2.16.840.1.113883.4.9" codeSystemName="UNII"></code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<effectiveTime>
<low value="19600101"/>
</effectiveTime>
<value xsi:type="CD" code="64144002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Rash"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" xsi:type="CE" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<statusCode code="completed"/>
<value xsi:type="CD" code="6736007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="moderate"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
</section>
</component>
<component>
<section classCode="DOCSECT" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.14" />
<code code="10160-0" displayName="History of medication use" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<title>Medications</title>
<text></text>
<entry>
<substanceAdministration classCode="SBADM" moodCode="INT" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.14" extension="24"/>
<statusCode code="active" />
<effectiveTime xsi:type="IVL_TS">
<low value="20130701000000"/>
</effectiveTime>
<routeCode nullFlavor="UNC">
<originalText>
<reference value="Topical Ointment"/>
</originalText>
</routeCode>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial classCode="MMAT">
<code code="204135" displayName="Desonide (Topical) Topical Ointment 0.0005 mg/mg" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" />
<name>Desonide</name>
<lotNumberText nullFlavor="UNK"/>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<entryRelationship typeCode="RSON">
<observation classCode="COND" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.19"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.13" extension="8"/>
<code code="404684003" displayName="Finding" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
<statusCode code="active" />
<value xsi:type="CE" code="195967001" displayName="Asthma" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" />
</observation>
</entryRelationship>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<act classCode="ACT" moodCode="INT">
<templateId root="2.16.840.1.113883.10.20.22.4.20"/>
<code code="394835006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Patient Medication Education"/>
<text>
take it
</text>
<statusCode code="completed"/>
</act>
</entryRelationship>
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="INT" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.16"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.14" extension="2"/>
<statusCode code="active" />
<effectiveTime xsi:type="IVL_TS">
<low value="20110715000000"/>
</effectiveTime>
<routeCode nullFlavor="UNC">
<originalText>
<reference value="Topical Gel"/>
</originalText>
</routeCode>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.23"/>
<manufacturedMaterial classCode="MMAT">
<code code="198706" displayName="Hydrocortisone (Topical) Topical Gel 0.01 mg/mg" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm" />
<name>Hydrocortisone</name>
<lotNumberText nullFlavor="UNK"/>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<entryRelationship typeCode="RSON">
<observation classCode="COND" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.19"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.13" extension="7"/>
<code code="404684003" displayName="Finding" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
<statusCode code="completed" />
<value xsi:type="CE" code="43116000" displayName="Eczema" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" />
</observation>
</entryRelationship>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<act classCode="ACT" moodCode="INT">
<templateId root="2.16.840.1.113883.10.20.22.4.20"/>
<code code="394835006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Patient Medication Education"/>
<text>
Apply twice daily to affected area
</text>
<statusCode code="completed"/>
</act>
</entryRelationship>
</substanceAdministration>
</entry>
</section>
</component>
<component>
<section classCode="DOCSECT" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.2.2.1"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" />
<code code="11369-6" displayName="History of immunizations" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<title>History Of Immunizations</title>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="1"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
Flu (Influenza) on 2011-08-13
</text>
<statusCode code="completed"/>
<effectiveTime value="20110813000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="88" displayName="Flu" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
<originalText>
Influenza
</originalText>
</code>
<name></name>
<lotNumberText nullFlavor="UNK" />
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<performer nullFlavor="UNK" />
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="2"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
DTaP (Diphtheria, Tetanus, Pertussis) on 2011-09-01
</text>
<statusCode code="completed"/>
<effectiveTime value="20110901000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="107" displayName="DTaP" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
<originalText>
Diphtheria, Tetanus, Pertussis
</originalText>
</code>
<name></name>
<lotNumberText nullFlavor="UNK" />
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<performer nullFlavor="UNK" />
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="3"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
Hib (Haemophilus influenzae type b) on 2011-09-01
</text>
<statusCode code="completed"/>
<effectiveTime value="20110901000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="17" displayName="Hib" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
<originalText>
Haemophilus influenzae type b
</originalText>
</code>
<name></name>
<lotNumberText nullFlavor="UNK" />
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<performer nullFlavor="UNK" />
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="4"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
HepB (Hepatitis B) on 2011-07-01
</text>
<statusCode code="completed"/>
<effectiveTime value="20110701000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="45" displayName="HepB" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
<originalText>
Hepatitis B
</originalText>
</code>
<name></name>
<lotNumberText nullFlavor="UNK" />
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<performer nullFlavor="UNK" />
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="5"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
HepB (Hepatitis B) on 2011-09-01
</text>
<statusCode code="completed"/>
<effectiveTime value="20110901000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="45" displayName="HepB" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
<originalText>
Hepatitis B
</originalText>
</code>
<name></name>
<lotNumberText nullFlavor="UNK" />
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<performer nullFlavor="UNK" />
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="6"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
IPV (Inactivated Poliovirus) on 2011-09-01
</text>
<statusCode code="completed"/>
<effectiveTime value="20110901000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="10" displayName="IPV" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
<originalText>
Inactivated Poliovirus
</originalText>
</code>
<name></name>
<lotNumberText nullFlavor="UNK" />
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<performer nullFlavor="UNK" />
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="7"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
PCV (Pneumococcal) on 2011-09-01
</text>
<statusCode code="completed"/>
<effectiveTime value="20110901000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="133" displayName="PCV" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
<originalText>
Pneumococcal
</originalText>
</code>
<name></name>
<lotNumberText nullFlavor="UNK" />
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<performer nullFlavor="UNK" />
</substanceAdministration>
</entry>
<entry>
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.52"/>
<id root="2.16.840.1.113883.3.3297.1.1.1.6.1.12" extension="8"/>
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
RV (Rotavirus) on 2011-09-01
</text>
<statusCode code="completed"/>
<effectiveTime value="20110901000000"/>
<routeCode nullFlavor="NA"/>
<approachSiteCode nullFlavor="NA"/>
<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
<manufacturedProduct classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.54"/>
<manufacturedMaterial classCode="MMAT">
<code code="122" displayName="RV" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
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Rotavirus
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DTaP (Diphtheria, Tetanus, Pertussis) on 2011-09-09
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Diphtheria, Tetanus, Pertussis
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Hib (Haemophilus influenzae type b) on 2011-09-09
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Haemophilus influenzae type b
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PCV (Pneumococcal) on 2011-09-09
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Pneumococcal
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RV (Rotavirus) on 2011-09-09
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<routeCode nullFlavor="NA"/>
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<code code="122" displayName="RV" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
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Rotavirus
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IPV (Inactivated Poliovirus) on 2011-11-01
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<statusCode code="completed"/>
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<doseQuantity nullFlavor="UNK" />
<consumable typeCode="CSM">
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<manufacturedMaterial classCode="MMAT">
<code code="10" displayName="IPV" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
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Inactivated Poliovirus
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<lotNumberText nullFlavor="UNK" />
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<performer nullFlavor="UNK" />
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<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
<text>
IPV (Inactivated Poliovirus) on 2011-11-04
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<statusCode code="completed"/>
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<manufacturedMaterial classCode="MMAT">
<code code="10" displayName="IPV" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
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Inactivated Poliovirus
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<lotNumberText nullFlavor="UNK" />
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<performer nullFlavor="UNK" />
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Hib (Haemophilus influenzae type b) on 2012-01-01
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Haemophilus influenzae type b
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PCV (Pneumococcal) on 2012-01-01
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<code code="133" displayName="PCV" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
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Pneumococcal
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RV (Rotavirus) on 2012-01-03
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<effectiveTime value="20120103000000"/>
<routeCode nullFlavor="NA"/>
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Rotavirus
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HepA (Hepatitis A) on 2013-01-09
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Hepatitis A
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DTaP (Diphtheria, Tetanus, Pertussis) on 2013-05-01
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<code code="107" displayName="DTaP" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX">
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Diphtheria, Tetanus, Pertussis
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