bluebutton/_site/bower_components/sample_ccdas/Vitera/Vitera_CCDA_SMART_Sample.xml

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<?xml version='1.0' encoding='UTF-8'?>
<?xml-stylesheet type='text/xsl' href='CCD.xsl'?>
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 CDA.xsd">
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  <id root="2.16.840.1.113883.3.140.1.0.6.1.13092597.12456139" />
  <code code="34133-9" displayName="Summarization of Episode Note" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
  <title>Full Chart - Madison Medical Center P. A.</title>
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      <addr>
        <streetAddressLine>3456 West Palm</streetAddressLine>
        <streetAddressLine>Apt. #34</streetAddressLine>
        <city>Madison</city>
        <state>CA</state>
        <country>US</country>
        <postalCode>95653</postalCode>
      </addr>
      <telecom value="tel:+1-916-555-3293" use="HP" />
      <telecom value="tel:+1-916-555-5544" use="WP" />
      <telecom value="mailto:carlsonsa@e4health.com" />
      <patient>
        <name>
          <given>Sharon</given>
          <given>A</given>
          <family>Carlson</family>
        </name>
        <administrativeGenderCode code="F" displayName="Female" codeSystem="2.16.840.1.113883.5.1" codeSystemName="AdministrativeGender" />
        <birthTime value="19381212" />
        <maritalStatusCode code="M" displayName="Married" codeSystem="2.16.840.1.113883.5.2" codeSystemName="MaritalStatus" />
        <raceCode code="2106-3" displayName="White" codeSystem="2.16.840.1.113883.6.238" codeSystemName="CDC Race and Ethnicity" />
        <ethnicGroupCode code="2135-2" displayName="Hispanic or Latino" codeSystem="2.16.840.1.113883.6.238" codeSystemName="CDC Race and Ethnicity" />
        <languageCommunication>
          <languageCode code="eng" />
          <preferenceInd value="true" />
        </languageCommunication>
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        <name>Madison Medical Center P. A.</name>
        <telecom value="tel:+1-916-555-7654" use="WP" />
        <telecom value="tel:+1-916-555-7657" use="WP" />
        <addr>
          <streetAddressLine>99 Sycamore Street</streetAddressLine>
          <streetAddressLine>Suite 3</streetAddressLine>
          <city>Gainesville</city>
          <state>FL</state>
          <country>US</country>
          <postalCode>32608</postalCode>
        </addr>
      </providerOrganization>
    </patientRole>
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  <author>
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        <streetAddressLine>99 Sycamore Street</streetAddressLine>
        <streetAddressLine>Suite 3</streetAddressLine>
        <city>Gainesville</city>
        <state>FL</state>
        <country>US</country>
        <postalCode>32608</postalCode>
      </addr>
      <telecom use="WP" value="tel:+1-916-555-7654" />
      <assignedPerson>
        <name>
          <given>David</given>
          <given>E</given>
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          <suffix>MD</suffix>
        </name>
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  </author>
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        <name>Madison Medical Center P. A.</name>
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          <city>Gainesville</city>
          <state>FL</state>
          <country>US</country>
          <postalCode>32608</postalCode>
        </addr>
      </representedCustodianOrganization>
    </assignedCustodian>
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  <informationRecipient>
    <intendedRecipient>
      <informationRecipient>
        <name>Sharon A. Carlson</name>
      </informationRecipient>
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        <streetAddressLine>3456 West Palm</streetAddressLine>
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        <state>FL</state>
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        <postalCode>123</postalCode>
      </addr>
      <telecom value="tel:+1-916-555-3293" use="HP" />
      <associatedPerson>
        <name>
          <given>Steven</given>
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        <streetAddressLine>3456 West Palm</streetAddressLine>
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        <city>Unknown</city>
        <state>FL</state>
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        <postalCode>123</postalCode>
      </addr>
      <telecom value="tel:+1-916-555-3293" use="HP" />
      <associatedPerson>
        <name>
          <given>Steven</given>
          <given>W</given>
          <family>Carlson</family>
        </name>
      </associatedPerson>
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  </participant>
  <documentationOf>
    <serviceEvent classCode="PCPR">
      <effectiveTime>
        <low value="20010101" />
        <high value="20130925" />
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      <performer typeCode="PRF">
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          <assignedPerson>
            <name>
              <given>Wendy</given>
              <given>M</given>
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              <suffix>PA</suffix>
            </name>
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          <representedOrganization>
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            <name>Madison Medical Center P. A.</name>
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            <addr>
              <streetAddressLine>99 Sycamore Street</streetAddressLine>
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              <city>Gainesville</city>
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        <assignedEntity classCode="ASSIGNED">
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          <addr>
            <streetAddressLine>34 Sycamore Street</streetAddressLine>
            <streetAddressLine>Suite 3</streetAddressLine>
            <city>Madison</city>
            <state>CA</state>
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            <postalCode>95653</postalCode>
          </addr>
          <telecom value="tel:+1-916-555-7657" use="WP" />
          <assignedPerson>
            <name>
              <given>Gary</given>
              <family>Madder</family>
              <suffix>MD</suffix>
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            <name>Madison Medical Center P. A.</name>
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            <addr>
              <streetAddressLine>99 Sycamore Street</streetAddressLine>
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          <low nullFlavor="NI" />
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        <assignedEntity classCode="ASSIGNED">
          <id root="2.16.840.1.113883.4.6" extension="9080089000" assigningAuthorityName="NPI" />
          <addr>
            <streetAddressLine>11554 Weedside Lane</streetAddressLine>
            <city>Madison</city>
            <state>CA</state>
            <country>US</country>
            <postalCode>95653</postalCode>
          </addr>
          <telecom value="tel:+1-916-555-7657" use="WP" />
          <assignedPerson>
            <name>
              <given>James</given>
              <given>T</given>
              <family>Monroe</family>
              <suffix>MD</suffix>
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          </assignedPerson>
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            <id root="2.16.840.1.113883.3.140.1.0.6" />
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            <telecom value="tel:+1-916-555-7657" use="WP" />
            <addr>
              <streetAddressLine>99 Sycamore Street</streetAddressLine>
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              <city>Gainesville</city>
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              <country>US</country>
              <postalCode>32608</postalCode>
            </addr>
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        <assignedEntity classCode="ASSIGNED">
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          <addr>
            <streetAddressLine>8620 Palmetto Drive</streetAddressLine>
            <city>Madison</city>
            <state>CA</state>
            <country>US</country>
            <postalCode>95653</postalCode>
          </addr>
          <telecom value="tel:+1-916-555-7657" use="WP" />
          <assignedPerson>
            <name>
              <given>Depak</given>
              <given>E</given>
              <family>Shah</family>
              <suffix>MD</suffix>
            </name>
          </assignedPerson>
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            <addr>
              <streetAddressLine>99 Sycamore Street</streetAddressLine>
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              <city>Gainesville</city>
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              <country>US</country>
              <postalCode>32608</postalCode>
            </addr>
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        <assignedEntity classCode="ASSIGNED">
          <id root="2.16.840.1.113883.4.6" extension="9990058700" assigningAuthorityName="NPI" />
          <addr>
            <streetAddressLine>87 Bayshore Drive</streetAddressLine>
            <city>Madison</city>
            <state>CA</state>
            <country>US</country>
            <postalCode>95653</postalCode>
          </addr>
          <telecom value="tel:+1-916-555-7657" use="WP" />
          <assignedPerson>
            <name>
              <given>David</given>
              <given>E</given>
              <family>Ford</family>
              <suffix>MD</suffix>
            </name>
          </assignedPerson>
          <representedOrganization>
            <id root="2.16.840.1.113883.3.140.1.0.6" />
            <name>Madison Medical Center P. A.</name>
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            <telecom value="tel:+1-916-555-7657" use="WP" />
            <addr>
              <streetAddressLine>99 Sycamore Street</streetAddressLine>
              <streetAddressLine>Suite 3</streetAddressLine>
              <city>Gainesville</city>
              <state>FL</state>
              <country>US</country>
              <postalCode>32608</postalCode>
            </addr>
          </representedOrganization>
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  </documentationOf>
  <authorization typeCode="AUTH">
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      <code code="N" displayName="Normal" codeSystem="1.3.6.1.4.1.21367.100.1" codeSystemName="Connectathon Confidentiality Codes" />
      <statusCode code="completed" />
    </consent>
  </authorization>
  <component>
    <structuredBody>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.5.1" assigningAuthorityName="CCDA Active Problems Section (Entries Required)" />
          <id root="eaa41941-02bb-412c-8f20-e0dc8bb7b5c3" />
          <code code="11450-4" displayName="Problem list" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
          <title>Problems</title>
          <text>
            <table width="100%">
              <thead>
                <tr>
                  <th>All Visits</th>
                  <th>Effective Date(s)</th>
                  <th>Provider</th>
                  <th>Condition Status</th>
                </tr>
              </thead>
              <tbody>
                <tr>
                  <td ID="problemDescriptionid0">COMN MIGRNE WO NTRC MGRN</td>
                  <td>12/02/2002</td>
                  <td>David E Ford MD</td>
                  <td ID="problemStatusId0">Active</td>
                </tr>
                <tr>
                  <td>
                  </td>
                  <td ID="problemCommentsId0" colspan="3">Note: Unchanged - Negative MRI of skull on 2/10/2003</td>
                </tr>
              </tbody>
            </table>
          </text>
          <entry typeCode="DRIV">
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                    <city>Madison</city>
                    <state>CA</state>
                    <country>US</country>
                    <postalCode>95653</postalCode>
                  </addr>
                  <telecom value="tel:+1-916-555-7657" use="WP" />
                  <assignedPerson>
                    <name>
                      <given>David</given>
                      <given>E</given>
                      <family>Ford</family>
                      <suffix>MD</suffix>
                    </name>
                  </assignedPerson>
                  <representedOrganization>
                    <id root="2.16.840.1.113883.3.140.1.0.6" extension="MMC" />
                    <name>Madison Medical Center P. A.</name>
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                    <telecom value="tel:+1-916-555-7657" use="WP" />
                    <addr>
                      <streetAddressLine>99 Sycamore Street</streetAddressLine>
                      <streetAddressLine>Suite 3</streetAddressLine>
                      <city>Gainesville</city>
                      <state>FL</state>
                      <country>US</country>
                      <postalCode>32608</postalCode>
                    </addr>
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              <entryRelationship typeCode="SUBJ" inversionInd="false">
                <observation classCode="OBS" moodCode="EVN" negationInd="false">
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                  <code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" />
                  <text>
                    <reference value="#problemDescriptionid0" />
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                  <statusCode code="completed" />
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                    <originalText>
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                    </originalText>
                    <translation code="346.10" displayName="COMN MIGRNE WO NTRC MGRN" codeSystem="2.16.840.1.113883.6.103" codeSystemName="ICD9CM" />
                  </value>
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                      <addr>
                        <streetAddressLine>99 Sycamore Street</streetAddressLine>
                        <streetAddressLine>Suite 3</streetAddressLine>
                        <city>Gainesville</city>
                        <state>FL</state>
                        <country>US</country>
                        <postalCode>32608</postalCode>
                      </addr>
                      <telecom value="tel:+1-916-555-7654" use="WP" />
                      <assignedPerson>
                        <name nullFlavor="UNK" />
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                      <representedOrganization>
                        <id root="2.16.840.1.113883.3.140.1.0.6" extension="MMC" />
                        <name>Madison Medical Center P. A.</name>
                        <telecom value="tel:+1-916-555-7654" use="WP" />
                        <telecom value="tel:+1-916-555-7657" use="WP" />
                        <addr>
                          <streetAddressLine>99 Sycamore Street</streetAddressLine>
                          <streetAddressLine>Suite 3</streetAddressLine>
                          <city>Gainesville</city>
                          <state>FL</state>
                          <country>US</country>
                          <postalCode>32608</postalCode>
                        </addr>
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                  <entryRelationship typeCode="REFR" inversionInd="false">
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                      <text>
                        <reference value="#problemStatusId0" />
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                      <statusCode code="completed" />
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                    </observation>
                  </entryRelationship>
                </observation>
              </entryRelationship>
              <entryRelationship typeCode="SUBJ" inversionInd="true">
                <act classCode="ACT" moodCode="EVN">
                  <templateId root="2.16.840.1.113883.10.20.22.4.64" assigningAuthorityName="CCDA Comment Activity" />
                  <code code="48767-8" displayName="Annotation comment" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
                  <text>
                    <reference value="#problemCommentsId0" />
                  </text>
                  <statusCode code="completed" />
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        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.10" assigningAuthorityName="CCDA Plan of Care Section" />
          <id root="194831af-8c25-40df-ad34-d3c5eb4c08d5" />
          <code code="18776-5" displayName="TREATMENT PLAN" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
          <title>Plan of Care</title>
          <text>
            <table width="100%">
              <thead>
                <tr>
                  <th>Pending Tests</th>
                  <th>Order</th>
                  <th>Diagnosis</th>
                  <th>Results Due</th>
                  <th>Ordering Provider</th>
                </tr>
              </thead>
              <tbody>
                <tr>
                  <td ID="pendingTestTypeDescriptionID0">Lab</td>
                  <td ID="pendingTestDescriptionID0">Metabolic Panel</td>
                  <td ID="pendingTestDiagnosisID0">
                  </td>
                  <td>01/03/08</td>
                  <td>James T Monroe MD</td>
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <thead>
                <tr>
                  <th>Future Tests</th>
                  <th>Order</th>
                  <th>Diagnosis</th>
                  <th>Results Due</th>
                  <th>Ordering Provider</th>
                </tr>
              </thead>
              <tbody>
                <tr>
                  <td ID="futureTestTypeDescriptionID0">Radiology - CT Scans</td>
                  <td ID="futureTestDescriptionID0">CT SCAN HEAD</td>
                  <td ID="futureTestDiagnosisID0">COMN MIGRNE WO NTRC MGRN</td>
                  <td>01/22/08</td>
                  <td>Depak E Shah MD</td>
                </tr>
              </tbody>
            </table>
          </text>
          <entry>
            <procedure classCode="PROC" moodCode="INT">
              <templateId root="2.16.840.1.113883.10.20.22.4.41" assigningAuthorityName="CCDA Plan of Care Activity Procedure" />
              <id root="2.16.840.1.113883.3.140.1.0.6.10.21" extension="2" />
              <text>
                <reference value="#pendingTestDescriptionID0" />
              </text>
              <effectiveTime>
                <low value="20130925" />
                <high value="20080103" />
              </effectiveTime>
              <performer typeCode="PRF">
                <assignedEntity classCode="ASSIGNED">
                  <id root="2.16.840.1.113883.4.6" extension="9080089000" assigningAuthorityName="NPI" />
                  <addr>
                    <streetAddressLine>11554 Weedside Lane</streetAddressLine>
                    <city>Madison</city>
                    <state>CA</state>
                    <country>US</country>
                    <postalCode>95653</postalCode>
                  </addr>
                  <telecom value="tel:+1-916-555-7657" use="WP" />
                  <assignedPerson>
                    <name>
                      <given>James</given>
                      <given>T</given>
                      <family>Monroe</family>
                      <suffix>MD</suffix>
                    </name>
                  </assignedPerson>
                  <representedOrganization>
                    <id root="2.16.840.1.113883.3.140.1.0.6" extension="MMC" />
                    <name>Madison Medical Center P. A.</name>
                    <telecom value="tel:+1-916-555-7654" use="WP" />
                    <telecom value="tel:+1-916-555-7657" use="WP" />
                    <addr>
                      <streetAddressLine>99 Sycamore Street</streetAddressLine>
                      <streetAddressLine>Suite 3</streetAddressLine>
                      <city>Gainesville</city>
                      <state>FL</state>
                      <country>US</country>
                      <postalCode>32608</postalCode>
                    </addr>
                  </representedOrganization>
                </assignedEntity>
              </performer>
            </procedure>
          </entry>
          <entry>
            <procedure classCode="PROC" moodCode="INT">
              <templateId root="2.16.840.1.113883.10.20.22.4.41" assigningAuthorityName="CCDA Plan of Care Activity Procedure" />
              <id root="2.16.840.1.113883.3.140.1.0.6.10.21" extension="46" />
              <text>
                <reference value="#futureTestDescriptionID0" />
              </text>
              <effectiveTime>
                <low value="20130925" />
                <high value="20080122" />
              </effectiveTime>
              <performer typeCode="PRF">
                <assignedEntity classCode="ASSIGNED">
                  <id root="2.16.840.1.113883.4.6" extension="9990054800" assigningAuthorityName="NPI" />
                  <addr>
                    <streetAddressLine>8620 Palmetto Drive</streetAddressLine>
                    <city>Madison</city>
                    <state>CA</state>
                    <country>US</country>
                    <postalCode>95653</postalCode>
                  </addr>
                  <telecom value="tel:+1-916-555-7657" use="WP" />
                  <assignedPerson>
                    <name>
                      <given>Depak</given>
                      <given>E</given>
                      <family>Shah</family>
                      <suffix>MD</suffix>
                    </name>
                  </assignedPerson>
                  <representedOrganization>
                    <id root="2.16.840.1.113883.3.140.1.0.6" extension="MMC" />
                    <name>Madison Medical Center P. A.</name>
                    <telecom value="tel:+1-916-555-7654" use="WP" />
                    <telecom value="tel:+1-916-555-7657" use="WP" />
                    <addr>
                      <streetAddressLine>99 Sycamore Street</streetAddressLine>
                      <streetAddressLine>Suite 3</streetAddressLine>
                      <city>Gainesville</city>
                      <state>FL</state>
                      <country>US</country>
                      <postalCode>32608</postalCode>
                    </addr>
                  </representedOrganization>
                </assignedEntity>
              </performer>
              <entryRelationship typeCode="SUBJ" inversionInd="false">
                <observation classCode="OBS" moodCode="EVN" negationInd="false">
                  <templateId root="2.16.840.1.113883.10.20.22.4.4" assigningAuthorityName="CCDA Problem Observation" />
                  <id root="d8ac288b-aba0-4e96-b398-9e6d240978cf" />
                  <code code="282291009" displayName="Diagnosis" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" />
                  <text>
                    <reference value="#futureTestDescriptionID0" />
                  </text>
                  <statusCode code="completed" />
                  <value code="346.10" displayName="COMN MIGRNE WO NTRC MGRN" codeSystem="2.16.840.1.113883.6.103" codeSystemName="ICD9CM" xsi:type="CD">
                    <originalText>
                      <reference value="#futureTestDescriptionID0" />
                    </originalText>
                  </value>
                </observation>
              </entryRelationship>
            </procedure>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.45" assigningAuthorityName="CCDA Instructions Section" />
          <id root="5d75f110-44ff-4cab-a72b-2c8f62548e1b" />
          <code code="69730-0" displayName="INSTRUCTIONS" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
          <title>Instructions</title>
          <text>
            <content>No Instructions Recorded</content>
          </text>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.1.1" assigningAuthorityName="CCDA Medications Section (Entries Required)" />
          <id root="5a288486-2ca4-4df2-8988-bab2f62eb3ed" />
          <code code="10160-0" displayName="HISTORY OF MEDICATION USE" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
          <title>Medications</title>
          <text>
            <table width="100%" cellspacing="0">
              <thead>
                <tr>
                  <th align="left">Current Medications (continue as prescribed)</th>
                  <th />
                  <th align="right">
                  </th>
                </tr>
              </thead>
              <tbody>
                <tr>
                  <td colspan="3" />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID0">12 Hour Decongestant 120 MG CP12</td>
                  <td>02/23/2010</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-0">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-0">
                  </td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%" cellspacing="0">
              <thead>
                <tr>
                  <th align="left">Past Medications on file</th>
                  <th />
                  <th align="right">
                  </th>
                </tr>
              </thead>
              <tbody>
                <tr>
                  <td colspan="3" />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID1">2nd Skin Blister Kit MISC</td>
                  <td>01/13/2012</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-1">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-1">
                  </td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID2">12 Hour Nasal Relief Spray 0.05 % SOLN</td>
                  <td>01/13/2012</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-2">
                  </td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID3">Prasad Schedule 4 Drug TBDR</td>
                  <td>02/16/2010</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-3">
                  </td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-3">2 twice a day , Test case 1 directions go here. All information existing.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID4">5-Hydroxy-L-Tryptophan POWD</td>
                  <td>11/02/2009</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-4">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-4">
                  </td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID5">Ginko Biloba 1 Gram CPSP</td>
                  <td>01/08/2008</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-5">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-5">Take one capsule with tea twice a day by mouth.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID6">Promethazine HCl 25 MG TABS</td>
                  <td>01/08/2008</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-6">NAUSEA ALONE</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-6">Take one tablet by mouth every four to six hours as needed.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID7">Naproxen Sodium 550 MG TABS</td>
                  <td>01/08/2008</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-7">COMN MIGRNE WO NTRC MGRN</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-7">Take one tablet by mouth every six hours as needed.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID8">Imitrex 25 MG TABS</td>
                  <td>01/03/2008 - 01/08/2008</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-8">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-8">Take 1 tablet by mouth at onset of symptoms.  Do not exceed 2 tablets daily.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID9">Valium 5 MG TABS</td>
                  <td>11/02/2007 - 02/01/2007</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-9">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-9">Take 1 tablet at bedtime.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID10">Imitrex 25 MG TABS</td>
                  <td>11/02/2007</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-10">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-10">Take 1 tablet as needed fror migraine headache.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID11">Imitrex 25 MG TABS</td>
                  <td>10/05/2007 - 11/02/2007</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-11">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-11">Take 1 tablet as directed at onset of headache.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID12">Stress Formula Plus Iron TABS</td>
                  <td>10/05/2007</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-12">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-12">Take 1 tablet once a day by mouth.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID13">Imitrex 25 MG TABS</td>
                  <td>09/03/2007 - 10/05/2007</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-13">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-13">Take 1 tablet as directed at onset of headache.</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID14">Fiorinal/Codeine #3 50-325-40-30 MG CAPS</td>
                  <td>09/03/2007 - 10/05/2007</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-14">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-14">1-2 tabs every 6 hours for pain, not to exceed 6 tablets a day</td>
                  <td />
                </tr>
              </tbody>
            </table>
            <table width="100%">
              <col />
              <col />
              <col width="1px" />
              <col width="40%" />
              <tbody>
                <tr>
                  <td ID="medicationDescriptionID15">Valium 5 MG TABS</td>
                  <td>02/01/2007 - 01/08/2008</td>
                  <td>Diagnosis:</td>
                  <td ID="medicationDiagnosis-15">Migraine Headache, Unspecified</td>
                </tr>
                <tr>
                  <td colspan="2">
                  </td>
                  <td />
                  <td rowspan="2">
                  </td>
                </tr>
                <tr>
                  <td colspan="2" ID="medicationDirections-15">Take 1 tablet at bedtime.</td>
                  <td />
                </tr>
              </tbody>
            </table>
          </text>
          <entry typeCode="DRIV">
            <substanceAdministration classCode="SBADM" moodCode="INT">
              <templateId root="2.16.840.1.113883.10.20.22.4.16" assigningAuthorityName="CCDA Medication Activity" />
              <id root="2.16.840.1.113883.3.140.1.0.6.10.8" extension="9801090" />
              <text>2 Puffs q6hrs prn</text>
              <statusCode code="completed" />
              <effectiveTime operator="A" xsi:type="IVL_TS">
                <low value="20100223" />
                <high nullFlavor="UNK" />
              </effectiveTime>
              <consumable>
                <manufacturedProduct classCode="MANU">
                  <templateId root="2.16.840.1.113883.10.20.22.4.23" assigningAuthorityName="CCDA Medication Information" />
                  <manufacturedMaterial>
                    <code code="Unknown" displayName="Unknown" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm">
                      <originalText>
                        <reference value="#medicationDescriptionID0" />
                      </originalText>
                      <translation code="86679" displayName="12 Hour Decongestant 120 MG CP12" codeSystem="2.16.840.1.113883.6.253" codeSystemName="MediSpan DDID" />
                    </code>
                    <name>12 Hour Decongestant</name>
                  </manufacturedMaterial>
                </manufacturedProduct>
              </consumable>
              <informant>
                <assignedEntity>
                  <id root="63eef114-6478-4115-9ac5-e43c35fa2558" />
                  <addr>
                    <streetAddressLine>99 Sycamore Street</streetAddressLine>
                    <streetAddressLine>Suite 3</streetAddressLine>
                    <city>Gainesville</city>
                    <state>FL</state>
                    <country>US</country>
                    <postalCode>32608</postalCode>
                  </addr>
                  <telecom value="tel:+1-916-555-7654" use="WP" />
                  <assignedPerson>
                    <name nullFlavor="UNK" />
                  </assignedPerson>
                  <representedOrganization>
                    <id root="2.16.840.1.113883.3.140.1.0.6" extension="MMC" />
                    <name>Madison Medical Center P. A.</name>
                    <telecom value="tel:+1-916-555-7654" use="WP" />
                    <telecom value="tel:+1-916-555-7657" use="WP" />
                    <addr>
                      <streetAddressLine>99 Sycamore Street</streetAddressLine>
                      <streetAddressLine>Suite 3</streetAddressLine>
                      <city>Gainesville</city>
                      <state>FL</state>
                      <country>US</country>
                      <postalCode>32608</postalCode>
                    </addr>
                  </representedOrganization>
                </assignedEntity>
              </informant>
              <entryRelationship typeCode="SUBJ">
                <observation classCode="OBS" moodCode="EVN">
                  <code code="73639000" displayName="Prescription Drug" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" />
                  <statusCode code="completed" />
                </observation>
              </entryRelationship>
              <entryRelationship typeCode="SUBJ" inversionInd="true">
                <act classCode="ACT" moodCode="INT">
                  <templateId root="2.16.840.1.113883.10.20.22.4.20" assigningAuthorityName="CCDA