Continuity of Care Document (C-CDA)

_:ClinicalDoc a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "2fb1e72f-d208-4394-bc35-1d2b6ada135b" ;  ];
    rim:Act.classCode [ dt:CD.code "DOCCLIN" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2013-02-18"^^xsd:date ;  
    rim:Act.code [
        dt:CD.code "34133-9" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "SUMMARIZATION OF EPISODE NOTE" ; dt:CD.codeSystemName "LOINC"
    ].
Patient Isabella Jones Language English
Date of birth May 1, 1947 Sex Female
Race White Ethnicity Not Hispanic or Latino
Contact info 1122 Mystical Rt 3
Beaverton, OR 97005, US
Tel: +1-5554445555
 Patient IDs 2.100
 
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "RCT" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:ClinicalDoc ;
    rim:Participation.role _:recordTarget0
] .
_:recordTarget0 a rim:Role ;
    rim:Role.id [ a dt:II ; dt:II.root "2.100" ];
    rim:Role.player _:recordTarget0_player ;
    rim:Role.scoper _:recordTarget0_scoper ;
    rim:Role.classCode [ dt:CD.code "PAT" ; dt:CD.codeSystem "???" ]    
    rim:Role.telecom [ a dt:COLL_TEL ; dt:COLL.item [ a dt:TEL ; dt:URL.address "tel:+1-5554445555" ; dt:TEL.use "HP" ;  ] ];
    rim:Role.addr [ a dt:COLL_AD ;
	# x:streetAddressLine "1122 Mystical Rt 3" ;
	# x:city "Beaverton" ;
	# x:state "OR" ;
	# x:postalCode "97005" ;
	# x:country "US" ;
      
    ] ;
.

_:recordTarget0_player a rim:Person ;
    rim:Entity.classCode [ dt:CD.code "PSN" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.determinerCode [ dt:CD.code "INSTANCE" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.code ???
    rim:Entity.name [ a dt:COLL_EN ;
        # dt:COLL.item [ x:person-name-family "Jones" ] ;
        # dt:COLL.item [ x:person-name-given "Isabella" ] ;
    ] ;
    rim:LivingSubject.administrativeGenderCode [
        dt:CD.code "F" ; dt:CD.codeSystem "2.16.840.1.113883.5.1" ;
        dt:CD.displayName "Female" ; dt:CD.codeSystemName "HL7 AdministrativeGender"
    ]
    rim:Act.effectiveTime "1947-05-01"^^xsd:date ;  
    rim:Person.raceCode [ a dt:DSET_CD ;
        COLL.item [
            dt:CD.code "2106-3" ; dt:CD.codeSystem "2.16.840.1.113883.6.238" ;
            dt:CD.displayName "White" ; dt:CD.codeSystemName "CDC Race and Ethnicity"
        ]    
    ] ; ;
    rim:Person.ethnicGroupCode [ a dt:DSET_CD ;
        COLL.item [
            dt:CD.code "2186-5" ; dt:CD.codeSystem "2.16.840.1.113883.6.238" ;
            dt:CD.displayName "Not Hispanic or Latino" ; dt:CD.codeSystemName "CDC Race and Ethnicity"
        ]    
    ] ; .
_:recordTarget0_scoper a rim:Organization ;
    rim:Entity.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "0001" ;  ];
    rim:Entity.id [ a dt:II ; dt:II.root "2.16.840.1.113883.4.6" ; dt:II.extension "1234567893" ;  ];
    rim:Entity.name [ a dt:COLL_EN ; # dt:COLL.item [ x:name "NEXTGEN Medical Practice (Horsham)" ] ;
    rim:Entity.telecom [ a dt:COLL_TEL ; dt:COLL.item [ a dt:TEL ; dt:URL.address "tel:+1-2156577010" ; dt:TEL.use "WP" ;  ] ];
    rim:Role.addr [ a dt:COLL_AD ;
	  # x:streetAddressLine "795 Horsham Road" ;
	  # x:city "Horsham" ;
	  # x:state "PA" ;
	  # x:postalCode "19044" ;
	
    ] ;
Document Id 2fb1e72f-d208-4394-bc35-1d2b6ada135b 2.201
Document Created: February 18, 2013, 03:10:00, EST
Performer Henry Seven , 1002 Healthcare Dr
Beaverton, OR 97005, US
Author NextGen Admin, NEXTGEN Medical Practice (Horsham)
Contact info 1002 Healthcare Dr
Beaverton, OR 97005
Tel: +1-5555551009
 
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "AUT" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:ClinicalDoc ;
    rim:Participation.role _:author0
] .
_:author0 a rim:Role ;
    rim:Role.id [ a dt:II ; dt:II.root "2.16.840.1.113883.4.6" ; dt:II.extension "1104152198" ;  ];
    rim:Role.player _:author0_player ;
    rim:Role.scoper _:author0_scoper ;
    rim:Role.classCode [ dt:CD.code "ASSIGNED" ; dt:CD.codeSystem "???" ]    
    rim:Role.telecom [ a dt:COLL_TEL ; dt:COLL.item [ a dt:TEL ; dt:URL.address "tel:+1-5555551009" ; dt:TEL.use "WP" ;  ] ];
    rim:Role.telecom [ a dt:COLL_TEL ; dt:COLL.item [ a dt:TEL ; dt:URL.address "mailto:Dscott@nextgen.com" ; dt:TEL.use "WP" ;  ] ];
    rim:Role.addr [ a dt:COLL_AD ;
	# x:streetAddressLine "1002 Healthcare Dr" ;
	# x:city "Beaverton" ;
	# x:state "OR" ;
	# x:postalCode "97005" ;
	# x:country "" ;
      
    ] ;
.

_:author0_player a rim:Person ;
    rim:Entity.classCode [ dt:CD.code "PSN" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.determinerCode [ dt:CD.code "INSTANCE" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.code ???
    rim:Entity.name [ a dt:COLL_EN ;
        # dt:COLL.item [ x:person-name-family "Admin" ] ;
        # dt:COLL.item [ x:person-name-given "NextGen" ] ;
    ] ;

 ;
 .
_:author0_scoper a rim:Organization ;
    rim:Entity.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "0001" ;  ];
    rim:Entity.id [ a dt:II ; dt:II.root "2.16.840.1.113883.4.6" ; dt:II.extension "1234567893" ;  ];
    rim:Entity.name [ a dt:COLL_EN ; # dt:COLL.item [ x:name "NEXTGEN Medical Practice (Horsham)" ] ;
    rim:Entity.telecom [ a dt:COLL_TEL ; dt:COLL.item [ a dt:TEL ; dt:URL.address "tel:+1-2156577010" ; dt:TEL.use "WP" ;  ] ];
    rim:Role.addr [ a dt:COLL_AD ;
	  # x:streetAddressLine "795 Horsham Road" ;
	  # x:city "Horsham" ;
	  # x:state "PA" ;
	  # x:postalCode "19044" ;
	
    ] ;
Signed NextGen Admin at ,
Contact info 1002 Healthcare Dr
Beaverton, OR 97005
Tel: +1-5555551009
Informant NextGen Admin of NEXTGEN Medical Practice (Horsham)
Contact info 1002 Healthcare Dr
Beaverton, OR 97005
Tel: +1-5555551009
Legal authenticator NextGen Admin of NEXTGEN Medical Practice (Horsham) signed at February 18, 2013, 03:10:00, EST
Contact info 1002 Healthcare Dr
Beaverton, OR 97005
Tel: +1-5555551009
Document maintained by NEXTGEN Medical Practice (Horsham)
Contact info 795 Horsham Road
Horsham, PA 19044, US
Tel: +1-2156577010

Table of Contents

[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component0
] .
_:component0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Alerts" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "48765-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "ALLERGIES, ADVERSE REACTIONS, ALERTS" ; dt:CD.codeSystemName "LOINC"
    ]

Allergies, Adverse Reactions, Alerts

Substance Reaction Severity Status
Codeine Shortness of Breath Unknown Active
aspirin Hives Unknown Active
PENICILLIN G BENZATHINE Hives Unknown Active 
<errorelement attr="value">content</errorelement>
# Allergy Problem Act # Allergy Problem Act # Allergy Problem Act 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component1
] .
_:component1 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Medications" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "10160-0" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "HISTORY OF MEDICATION USE" ; dt:CD.codeSystemName "LOINC"
    ]

Medications

Medication Instructions Dosage Effective Dates (start - stop) Status Comments
metoprolol tartrate 25 mg tablet take 1 tablet by oral route every day 25 MG Feb-12-2013 - Active
clarithromycin 500 mg tablet take 1 tablet by oral route 2 times daily for 7 days Aug-06-2012 - Active
albuterol sulfate HFA 90 mcg/actuation Aerosol Inhaler inhale 2 puff by inhalation route every 4 - 6 hours as needed as needed for Wheezing 0 Apr-02-2012 - Apr-02-2013 Active
albuterol sulfate HFA 90 mcg/actuation Aerosol Inhaler inhale 2 puffs once as needed Aug-06-2012 - Aug-06-2012 No Longer Active Administered in office
# Medication Activity # Medication Activity # Medication Activity # Medication Activity 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component2
] .
_:component2 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Problems" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "11450-4" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "PROBLEM LIST" ; dt:CD.codeSystemName "LOINC"
    ]

Problems

Condition Effective Dates (start - stop) Clinical Status
Community acquired pneumonia Jan-25-2013 - Active
Asthma Jan-25-2013 - Controlled
Hypoxemia Jan-25-2013 - Mild
# Problem Concern Act (Condition) # Problem Concern Act (Condition) # Problem Concern Act (Condition) 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component3
] .
_:component3 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Procedures" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "47519-4" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "HISTORY OF PROCEDURES" ; dt:CD.codeSystemName "LOINC"
    ]

Procedures

Procedure Date
Immunization admin, 1 vaccine Jan-25-2013
Immunization admin, 1 vaccine Jan-25-2013
Immunization admin, 1 vaccine Jan-25-2013
Immunization admin, 1 vaccine Jan-25-2013
CHEST COMPRESSION GEN SYSTEM Aug-06-2012
# Procedure Activity Procedure # Procedure Activity Procedure # Procedure Activity Procedure # Procedure Activity Procedure # Procedure Activity Procedure 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component4
] .
_:component4 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Results" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "30954-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "STUDIES SUMMARY" ; dt:CD.codeSystemName "LOINC"
    ]

Results

Test Name Date and Time Measure Units Reference Range Abnormal Flag Comments
Unknown
# Result Organizer {Result Observation} 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component5
] .
_:component5 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "AdvanceDirectives" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "42348-3" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "ADVANCE DIRECTIVES" ; dt:CD.codeSystemName "LOINC"
    ]

Advance Directives

Directive Yes / No Effective Date
Resuscitation Yes 8/6/2012
Life Support Yes 8/6/2012
Intubation Yes 8/6/2012
Antibiotics Yes 8/6/2012
IV Fluid Support Yes 8/6/2012
Tube Feed Yes 8/6/2012
CPR Yes 8/6/2012
Other Directive Yes 8/6/2012

WARNING:The information contained in this section is historical and is provided for information only and does not constitute a legal document or any assurance that the information is still accurate. Please verify the information with the holder of the legal document before using it for clinical purposes.

# Advance Directive Observation 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component6
] .
_:component6 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Encounters" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "46240-8" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "HISTORY OF ENCOUNTERS" ; dt:CD.codeSystemName "LOINC"
    ]

Encounters

Encounter Practice Location Reason(s) For Visit Diagnoses Date
Patient Visit NEXTGEN Medical Practice (Horsham), 795 Horsham Road, Horsham, PA, 19044 tel:+1-2156577010 Get Well Clinic
  • Mild Fever, 2 days
  • Chills, 2 days
  • Cough productive of greenish sputum, 2 days
  • Hypoxemia
  • Community acquired pneumonia
  • Asthma
 Aug-06-2012
# Encounter Activities 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component7
] .
_:component7 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "FamilyHistory" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "10157-6" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "HISTORY OF FAMILY MEMBER DISEASES" ; dt:CD.codeSystemName "LOINC"
    ]

Family History

Family Member Diagnosis Age At Onset Status
Unknown 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component8
] .
_:component8 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Immunizations" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "11369-6" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "HISTORY OF IMMUNIZATIONS" ; dt:CD.codeSystemName "LOINC"
    ]

Immunizations

Vaccine Date Status Comments
Pneumo (2 yrs or older) (PPV23) Aug-06-2012 completed - Completed reason: New
Influenza Virus vaccine Sep-10-2011 completed - Completed reason: New
Influenza Virus vaccine Nov-01-2010 completed - Completed reason: New
Td (7 yrs or older) Jan-04-2007 completed - Completed reason: New
# Immunization Activity
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "@@x_ActRelationshipEntry" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8 ;
    rim:ActRelationship.target _:component8_immunizationActivity0
] .
_:component8_immunizationActivity0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "45d0cab8-881c-43e5-84e6-450a16fed1b7" ];
    rim:Act.classCode [ dt:CD.code "SBADM" ; dt:CD.codeSystem "???" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2012-08-06"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "IMMUNIZ" ; dt:CD.codeSystem "2.16.840.1.113883.5.4" ;
        dt:CD.codeSystemName "ActCode"
    ];
    rim:SubstanceAdministration.doseQuantity [ a dt:PQ ; # unknown units 
        dt:PQ.value [
            dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
            dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
        ] 
    ] ;.

# Consumable ManufacturedMaterial
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "CSM" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity0 ;
    rim:Participation.role _:component8_immunizationActivity0_consumable0_role
] .
_:component8_immunizationActivity0_consumable0_role a rim:Role ;
    rim:Role.player _:component8_immunizationActivity0_consumable0_role_player ;

    rim:Role.classCode [ dt:CD.code "MANU" ; dt:CD.codeSystem "???" ]    
.



_:component8_immunizationActivity0_consumable0_player a rim:ManufacturedMaterial ;
    rim:Entity.classCode [ dt:CD.code "MMAT" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.determinerCode [ dt:CD.code "???" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.code [
        dt:CD.code "33" ; dt:CD.codeSystem "2.16.840.1.113883.12.292" ;
        dt:CD.displayName "Pneumo (2 yrs or older) (PPV23)" ; dt:CD.codeSystemName "CVX"
    ];
    rim:ManufacturedMaterial.lotNumberText [ dt:ED.value "90390" ] ;
    # rim:ManufacturedMaterial.manufacturerOrganization "GlaxoSmithKline"
.

# Performer Participation
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "PRF" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity0 ;
    rim:Participation.role _:component8_immunizationActivity0_performer0_role
] .
_:component8_immunizationActivity0_performer0_role a rim:Role ;
    rim:Role.id [ a dt:II ; dt:II.root "2.401" ; dt:II.extension "f3fdfa1a-6d4b-4ecd-889b-fe6e7798425e" ;  ];
    rim:Role.player _:component8_immunizationActivity0_performer0_role_player ;

    rim:Role.classCode [ dt:CD.code "ASSIGNED" ; dt:CD.codeSystem "???" ]    
    rim:Role.telecom [ a dt:COLL_TEL ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Role.addr [ a dt:COLL_AD ;
    ] ;
.



_:component8_immunizationActivity0_performer0_role_player a rim:Person ;
    rim:Entity.classCode [ dt:CD.code "PSN" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.determinerCode [ dt:CD.code "INSTANCE" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.code ???
    rim:Entity.name [ a dt:COLL_EN ;
        # dt:COLL.item [ x:person-name-family "Villalon RN" ] ;
        # dt:COLL.item [ x:person-name-given "May" ] ;
    ] ;

 ;
 .

# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity0 ;
    rim:ActRelationship.target _:component8_immunizationActivity0_entryRelationship0
] .
_:component8_immunizationActivity0_entryRelationship0 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "30973-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "DOSE NUMBER" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ; # unknown units 
        dt:PQ.value [ a dt:REAL ; dt:value "999" ] 
    ] ;;.  
# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity0 ;
    rim:ActRelationship.target _:component8_immunizationActivity0_entryRelationship1
] .
_:component8_immunizationActivity0_entryRelationship1 a rim:Act ;
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "48767-8" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "ANNOTATION COMMENT" ; dt:CD.codeSystemName "LOINC"
    ];.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity0 ;
    rim:ActRelationship.target _:component8_immunizationActivity0_entryRelationship2
] .
_:component8_immunizationActivity0_entryRelationship2 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "33999-4" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "STATUS" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:CD.code [ a dt:CD ;
            CD:code "39252100" ; CD:codeSystem "2.16.840.1.113883.6.96" ;
            CD:displayName "Prior History" ; CD:codeSystemName "SNOMED CT"
        ] 
    ] ;;.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity0 ;
    rim:ActRelationship.target _:component8_immunizationActivity0_entryRelationship3
] .
_:component8_immunizationActivity0_entryRelationship3 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.
# Immunization Activity
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "@@x_ActRelationshipEntry" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8 ;
    rim:ActRelationship.target _:component8_immunizationActivity1
] .
_:component8_immunizationActivity1 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "51d80996-a587-492c-ada6-8b69299e222b" ];
    rim:Act.classCode [ dt:CD.code "SBADM" ; dt:CD.codeSystem "???" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2011-09-10"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "IMMUNIZ" ; dt:CD.codeSystem "2.16.840.1.113883.5.4" ;
        dt:CD.codeSystemName "ActCode"
    ];
    rim:SubstanceAdministration.doseQuantity [ a dt:PQ ; # unknown units 
        dt:PQ.value [
            dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
            dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
        ] 
    ] ;.

# Consumable ManufacturedMaterial
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "CSM" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity1 ;
    rim:Participation.role _:component8_immunizationActivity1_consumable0_role
] .
_:component8_immunizationActivity1_consumable0_role a rim:Role ;
    rim:Role.player _:component8_immunizationActivity1_consumable0_role_player ;

    rim:Role.classCode [ dt:CD.code "MANU" ; dt:CD.codeSystem "???" ]    
.



_:component8_immunizationActivity1_consumable0_player a rim:ManufacturedMaterial ;
    rim:Entity.classCode [ dt:CD.code "MMAT" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.determinerCode [ dt:CD.code "???" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.code [
        dt:CD.code "88" ; dt:CD.codeSystem "2.16.840.1.113883.12.292" ;
        dt:CD.displayName "Influenza Virus vaccine" ; dt:CD.codeSystemName "CVX"
    ];
    rim:ManufacturedMaterial.lotNumberText [ dt:ED.value "839208" ] ;
    # rim:ManufacturedMaterial.manufacturerOrganization "Vaccine Company"
.

# Performer Participation
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "PRF" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity1 ;
    rim:Participation.role _:component8_immunizationActivity1_performer0_role
] .
_:component8_immunizationActivity1_performer0_role a rim:Role ;
    rim:Role.id [ a dt:II ; dt:II.root "2.401" ; dt:II.extension "f3fdfa1a-6d4b-4ecd-889b-fe6e7798425e" ;  ];
    rim:Role.player _:component8_immunizationActivity1_performer0_role_player ;

    rim:Role.classCode [ dt:CD.code "ASSIGNED" ; dt:CD.codeSystem "???" ]    
    rim:Role.telecom [ a dt:COLL_TEL ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Role.addr [ a dt:COLL_AD ;
    ] ;
.



_:component8_immunizationActivity1_performer0_role_player a rim:Person ;
    rim:Entity.classCode [ dt:CD.code "PSN" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.determinerCode [ dt:CD.code "INSTANCE" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.code ???
    rim:Entity.name [ a dt:COLL_EN ;
        # dt:COLL.item [ x:person-name-family "Villalon RN" ] ;
        # dt:COLL.item [ x:person-name-given "May" ] ;
    ] ;

 ;
 .

# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity1 ;
    rim:ActRelationship.target _:component8_immunizationActivity1_entryRelationship0
] .
_:component8_immunizationActivity1_entryRelationship0 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "30973-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "DOSE NUMBER" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ; # unknown units 
        dt:PQ.value [ a dt:REAL ; dt:value "999" ] 
    ] ;;.  
# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity1 ;
    rim:ActRelationship.target _:component8_immunizationActivity1_entryRelationship1
] .
_:component8_immunizationActivity1_entryRelationship1 a rim:Act ;
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "48767-8" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "ANNOTATION COMMENT" ; dt:CD.codeSystemName "LOINC"
    ];.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity1 ;
    rim:ActRelationship.target _:component8_immunizationActivity1_entryRelationship2
] .
_:component8_immunizationActivity1_entryRelationship2 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "33999-4" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "STATUS" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:CD.code [ a dt:CD ;
            CD:code "39252100" ; CD:codeSystem "2.16.840.1.113883.6.96" ;
            CD:displayName "Prior History" ; CD:codeSystemName "SNOMED CT"
        ] 
    ] ;;.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity1 ;
    rim:ActRelationship.target _:component8_immunizationActivity1_entryRelationship3
] .
_:component8_immunizationActivity1_entryRelationship3 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.
# Immunization Activity
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "@@x_ActRelationshipEntry" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8 ;
    rim:ActRelationship.target _:component8_immunizationActivity2
] .
_:component8_immunizationActivity2 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "73dd7cb8-2d2f-4380-92b7-a890db7d8661" ];
    rim:Act.classCode [ dt:CD.code "SBADM" ; dt:CD.codeSystem "???" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2010-11-01"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "IMMUNIZ" ; dt:CD.codeSystem "2.16.840.1.113883.5.4" ;
        dt:CD.codeSystemName "ActCode"
    ];
    rim:SubstanceAdministration.doseQuantity [ a dt:PQ ; # unknown units 
        dt:PQ.value [
            dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
            dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
        ] 
    ] ;.

# Consumable ManufacturedMaterial
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "CSM" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity2 ;
    rim:Participation.role _:component8_immunizationActivity2_consumable0_role
] .
_:component8_immunizationActivity2_consumable0_role a rim:Role ;
    rim:Role.player _:component8_immunizationActivity2_consumable0_role_player ;

    rim:Role.classCode [ dt:CD.code "MANU" ; dt:CD.codeSystem "???" ]    
.



_:component8_immunizationActivity2_consumable0_player a rim:ManufacturedMaterial ;
    rim:Entity.classCode [ dt:CD.code "MMAT" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.determinerCode [ dt:CD.code "???" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.code [
        dt:CD.code "88" ; dt:CD.codeSystem "2.16.840.1.113883.12.292" ;
        dt:CD.displayName "Influenza Virus vaccine" ; dt:CD.codeSystemName "CVX"
    ];
    rim:ManufacturedMaterial.lotNumberText [ dt:ED.value "839208" ] ;
    # rim:ManufacturedMaterial.manufacturerOrganization "Vaccine Company"
.

# Performer Participation
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "PRF" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity2 ;
    rim:Participation.role _:component8_immunizationActivity2_performer0_role
] .
_:component8_immunizationActivity2_performer0_role a rim:Role ;
    rim:Role.id [ a dt:II ; dt:II.root "2.401" ; dt:II.extension "f3fdfa1a-6d4b-4ecd-889b-fe6e7798425e" ;  ];
    rim:Role.player _:component8_immunizationActivity2_performer0_role_player ;

    rim:Role.classCode [ dt:CD.code "ASSIGNED" ; dt:CD.codeSystem "???" ]    
    rim:Role.telecom [ a dt:COLL_TEL ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Role.addr [ a dt:COLL_AD ;
    ] ;
.



_:component8_immunizationActivity2_performer0_role_player a rim:Person ;
    rim:Entity.classCode [ dt:CD.code "PSN" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.determinerCode [ dt:CD.code "INSTANCE" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.code ???
    rim:Entity.name [ a dt:COLL_EN ;
        # dt:COLL.item [ x:person-name-family "Villalon RN" ] ;
        # dt:COLL.item [ x:person-name-given "May" ] ;
    ] ;

 ;
 .

# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity2 ;
    rim:ActRelationship.target _:component8_immunizationActivity2_entryRelationship0
] .
_:component8_immunizationActivity2_entryRelationship0 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "30973-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "DOSE NUMBER" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ; # unknown units 
        dt:PQ.value [ a dt:REAL ; dt:value "999" ] 
    ] ;;.  
# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity2 ;
    rim:ActRelationship.target _:component8_immunizationActivity2_entryRelationship1
] .
_:component8_immunizationActivity2_entryRelationship1 a rim:Act ;
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "48767-8" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "ANNOTATION COMMENT" ; dt:CD.codeSystemName "LOINC"
    ];.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity2 ;
    rim:ActRelationship.target _:component8_immunizationActivity2_entryRelationship2
] .
_:component8_immunizationActivity2_entryRelationship2 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "33999-4" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "STATUS" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:CD.code [ a dt:CD ;
            CD:code "39252100" ; CD:codeSystem "2.16.840.1.113883.6.96" ;
            CD:displayName "Prior History" ; CD:codeSystemName "SNOMED CT"
        ] 
    ] ;;.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity2 ;
    rim:ActRelationship.target _:component8_immunizationActivity2_entryRelationship3
] .
_:component8_immunizationActivity2_entryRelationship3 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.
# Immunization Activity
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "@@x_ActRelationshipEntry" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8 ;
    rim:ActRelationship.target _:component8_immunizationActivity3
] .
_:component8_immunizationActivity3 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "ed5dd02a-a598-4b42-b344-8c84365b2380" ];
    rim:Act.classCode [ dt:CD.code "SBADM" ; dt:CD.codeSystem "???" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2007-01-04"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "IMMUNIZ" ; dt:CD.codeSystem "2.16.840.1.113883.5.4" ;
        dt:CD.codeSystemName "ActCode"
    ];
    rim:SubstanceAdministration.doseQuantity [ a dt:PQ ; # unknown units 
        dt:PQ.value [
            dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
            dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
        ] 
    ] ;.

# Consumable ManufacturedMaterial
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "CSM" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity3 ;
    rim:Participation.role _:component8_immunizationActivity3_consumable0_role
] .
_:component8_immunizationActivity3_consumable0_role a rim:Role ;
    rim:Role.player _:component8_immunizationActivity3_consumable0_role_player ;

    rim:Role.classCode [ dt:CD.code "MANU" ; dt:CD.codeSystem "???" ]    
.



_:component8_immunizationActivity3_consumable0_player a rim:ManufacturedMaterial ;
    rim:Entity.classCode [ dt:CD.code "MMAT" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.determinerCode [ dt:CD.code "???" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.code [
        dt:CD.code "09" ; dt:CD.codeSystem "2.16.840.1.113883.12.292" ;
        dt:CD.displayName "Td (7 yrs or older)" ; dt:CD.codeSystemName "CVX"
    ];
    rim:ManufacturedMaterial.lotNumberText [ dt:ED.value "90289" ] ;
    # rim:ManufacturedMaterial.manufacturerOrganization "GlaxoSmithKline"
.

# Performer Participation
[ a rim:Participation ;
    rim:Participation.typeCode [ dt:CD.code "PRF" ; dt:CD.codeSystem "???" ] ;
    rim:Participation.act _:component8_immunizationActivity3 ;
    rim:Participation.role _:component8_immunizationActivity3_performer0_role
] .
_:component8_immunizationActivity3_performer0_role a rim:Role ;
    rim:Role.id [ a dt:II ; dt:II.root "2.401" ; dt:II.extension "f3fdfa1a-6d4b-4ecd-889b-fe6e7798425e" ;  ];
    rim:Role.player _:component8_immunizationActivity3_performer0_role_player ;

    rim:Role.classCode [ dt:CD.code "ASSIGNED" ; dt:CD.codeSystem "???" ]    
    rim:Role.telecom [ a dt:COLL_TEL ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Role.addr [ a dt:COLL_AD ;
    ] ;
.



_:component8_immunizationActivity3_performer0_role_player a rim:Person ;
    rim:Entity.classCode [ dt:CD.code "PSN" ; dt:CD.codeSystem "???" ] ;
    rim:Entity.determinerCode [ dt:CD.code "INSTANCE" ; dt:CD.codeSystem "???" ] ;
    # rim:Entity.code ???
    rim:Entity.name [ a dt:COLL_EN ;
        # dt:COLL.item [ x:person-name-family "Villalon RN" ] ;
        # dt:COLL.item [ x:person-name-given "May" ] ;
    ] ;

 ;
 .

# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity3 ;
    rim:ActRelationship.target _:component8_immunizationActivity3_entryRelationship0
] .
_:component8_immunizationActivity3_entryRelationship0 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "30973-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "DOSE NUMBER" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ; # unknown units 
        dt:PQ.value [ a dt:REAL ; dt:value "999" ] 
    ] ;;.  
# SUBJ
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity3 ;
    rim:ActRelationship.target _:component8_immunizationActivity3_entryRelationship1
] .
_:component8_immunizationActivity3_entryRelationship1 a rim:Act ;
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "48767-8" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "ANNOTATION COMMENT" ; dt:CD.codeSystemName "LOINC"
    ];.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity3 ;
    rim:ActRelationship.target _:component8_immunizationActivity3_entryRelationship2
] .
_:component8_immunizationActivity3_entryRelationship2 a rim:Observation ;
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "33999-4" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "STATUS" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:CD.code [ a dt:CD ;
            CD:code "39252100" ; CD:codeSystem "2.16.840.1.113883.6.96" ;
            CD:displayName "Prior History" ; CD:codeSystemName "SNOMED CT"
        ] 
    ] ;;.  
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component8_immunizationActivity3 ;
    rim:ActRelationship.target _:component8_immunizationActivity3_entryRelationship3
] .
_:component8_immunizationActivity3_entryRelationship3 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.  
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component9
] .
_:component9 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Payer" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "48768-6" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "PAYMENT SOURCES" ; dt:CD.codeSystemName "LOINC"
    ]

Payers

Payer name Insurance type Covered party ID Authorization(s)
Unknown 
<act classCode="ACT" moodCode="EVN">
		<id nullFlavor="UNK"></id>
		<code nullFlavor="UNK"></code>
	      </act>
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component10
] .
_:component10 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "SocialHistory" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "29762-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "SOCIAL HISTORY" ; dt:CD.codeSystemName "LOINC"
    ]

Social History

Description Quantity Date
Smoking Status Current every day smoker 1992
# Smoking Status Observation
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "@@x_ActRelationshipEntry" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component10 ;
    rim:ActRelationship.target _:component10_smokingStatusObservation0
] .
_:component10_smokingStatusObservation0 a rim:Act ;
    rim:Act.classCode [ dt:CD.code "@@x_ActClassDocumentEntryAct" ; dt:CD.codeSystem "???" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "--"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "ASSERTION" ; dt:CD.codeSystem "2.16.840.1.113883.5.4" ;
        dt:CD.codeSystemName "HL7ActCode"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:CD.code [ a dt:CD ;
            CD:code "449868002" ; CD:codeSystem "2.16.840.1.113883.6.96" ;
            CD:displayName "Current every day smoker" ; CD:codeSystemName "SNOMED CT"
        ] 
    ] ;.
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component11
] .
_:component11 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "VitalSigns" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "8716-3" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "PHYSICAL FINDINGS" ; dt:CD.codeSystemName "LOINC"
    ]

Vital Signs

Date / Time: Height Weight BMI Pulse Rate Blood Pressure Temperature Respiratory Rate Body Surface Area Head Circumference
Aug-06-2012/12:13:00 69.69 in 194.01 lbs 28.08 135/92 mm[Hg]
# Vital Signs Organizer
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "@@x_ActRelationshipEntry" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0
] .
_:component11_vitalSignsOrganizer0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Act.classCode [ dt:CD.code "@@x_ActClassDocumentEntryAct" ; dt:CD.codeSystem "???" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2012-08-06"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "46680005" ; dt:CD.codeSystem "2.16.840.1.113883.6.96" ;
        dt:CD.displayName "Vital signs" ; dt:CD.codeSystemName "SNOMED CT"
    ].

# organizer contents: {
# Vital Sign Observation[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component0
] .
_:component11_vitalSignsOrganizer0_component0 a rim:Observation ;
    rim:Act.id [ a dt:II ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2012-08-06"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "8302-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "Body Height (Measured)" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:PQ.unit [ a dt:CS ;
            dt:CD.code "[in_us]" ; dt:CD.codeSystem "2.16.840.1.113883.6.8" ;
            dt:codeSystemName "UCUM" ; dt:CD.valueSet "2.16.840.1.113883.1.11.12839"
	] ;
        dt:PQ.value [ a dt:REAL ; dt:value "69.69" ] 
    ] ;.

    
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0_component0 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component0_entryRelationship0
] .
_:component11_vitalSignsOrganizer0_component0_entryRelationship0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.  
# Vital Sign Observation[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component1
] .
_:component11_vitalSignsOrganizer0_component1 a rim:Observation ;
    rim:Act.id [ a dt:II ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2012-08-06"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "3141-9" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "Body Weight (Measured)" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:PQ.unit [ a dt:CS ;
            dt:CD.code "[lb_av]" ; dt:CD.codeSystem "2.16.840.1.113883.6.8" ;
            dt:codeSystemName "UCUM" ; dt:CD.valueSet "2.16.840.1.113883.1.11.12839"
	] ;
        dt:PQ.value [ a dt:REAL ; dt:value "194.01" ] 
    ] ;.

    
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0_component1 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component1_entryRelationship0
] .
_:component11_vitalSignsOrganizer0_component1_entryRelationship0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.  
# Vital Sign Observation[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component2
] .
_:component11_vitalSignsOrganizer0_component2 a rim:Observation ;
    rim:Act.id [ a dt:II ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2012-08-06"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "8480-6" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "Intravascular Systolic" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:PQ.unit [ a dt:CS ;
            dt:CD.code "mm[Hg]" ; dt:CD.codeSystem "2.16.840.1.113883.6.8" ;
            dt:codeSystemName "UCUM" ; dt:CD.valueSet "2.16.840.1.113883.1.11.12839"
	] ;
        dt:PQ.value [ a dt:REAL ; dt:value "135" ] 
    ] ;.

    
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0_component2 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component2_entryRelationship0
] .
_:component11_vitalSignsOrganizer0_component2_entryRelationship0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.  
# Vital Sign Observation[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component3
] .
_:component11_vitalSignsOrganizer0_component3 a rim:Observation ;
    rim:Act.id [ a dt:II ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2012-08-06"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "8462-4" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "Intravascular Diastolic" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ;
        dt:PQ.unit [ a dt:CS ;
            dt:CD.code "mm[Hg]" ; dt:CD.codeSystem "2.16.840.1.113883.6.8" ;
            dt:codeSystemName "UCUM" ; dt:CD.valueSet "2.16.840.1.113883.1.11.12839"
	] ;
        dt:PQ.value [ a dt:REAL ; dt:value "92" ] 
    ] ;.

    
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0_component3 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component3_entryRelationship0
] .
_:component11_vitalSignsOrganizer0_component3_entryRelationship0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.  
# Vital Sign Observation[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component4
] .
_:component11_vitalSignsOrganizer0_component4 a rim:Observation ;
    rim:Act.id [ a dt:II ; dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ];
    rim:Act.classCode [ dt:CD.code "OBS" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.effectiveTime "2012-08-06"^^xsd:date ;  
    rim:Act.statusCode "completed" ;
  
    rim:Act.code [
        dt:CD.code "39156-5" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "BMI (Body Mass Index)" ; dt:CD.codeSystemName "LOINC"
    ];
    rim:Observation.value [ a dt:PQ ; # unknown units 
        dt:PQ.value [ a dt:REAL ; dt:value "28.08" ] 
    ] ;.

    
# REFR
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "REFR" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:component11_vitalSignsOrganizer0_component4 ;
    rim:ActRelationship.target _:component11_vitalSignsOrganizer0_component4_entryRelationship0
] .
_:component11_vitalSignsOrganizer0_component4_entryRelationship0 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "a778b36c-2a08-4f41-bc2a-3f29293c4e3c" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "UNK" ; dt:CD.codeSystem "@@HL7 UNK code system" ;
        dt:CD.displayName "@@beats me" ; dt:CD.codeSystemName "@@HL7"
    ];.  # }
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component12
] .
_:component12 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "ReasonForVisit" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "29299-5" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "REASON FOR VISIT" ; dt:CD.codeSystemName "LOINC"
    ]

Reason For Visit

*** Most recent encounter only, dated '08/06/2012 10:59'. ***

Mild Fever, 2 days

Chills, 2 days

Cough productive of greenish sputum, 2 days

[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component13
] .
_:component13 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "ReferralReason" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "42349-1" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "REASON FOR REFERRAL" ; dt:CD.codeSystemName "LOINC"
    ]

Reason For Referral

Reason For Referral
Unknown 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component14
] .
_:component14 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "PlanOfCare" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "18776-5" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "TREATMENT PLAN" ; dt:CD.codeSystemName "LOINC"
    ]

Plan Of Care

Date Type Action Status
Feb-12-2013 Goal Colonoscopy. Due on Sep-22-2012 due
Feb-15-2013 Referral referred to Penny Puffer, MD Pulmonary Disease For consultation, 555-555-1049, 1047 Healthcare Dr, Portland, OR 97005 -today 08/20/2012 (related to Community acquired pneumonia) ordered
02/20/2013 09:00 Appointment Jones, Isabella --- Dr. Henry Seven, 1007 Healthcare Dr., Portland, OR 99123 On Test Date + 3 Weeks BOOKED
02/19/2013 08:10 Appointment Jones, Isabella BOOKED
Aug-06-2012 Patient Education Stopping Smoking: After Your Visit completed
Feb-18-2013 Future Order: Lab Order Sputum Culture (Sputum Clt), Collected on: Aug-06-2012 Ordered
Feb-18-2013 Future Order: Radiology Order Chest X-ray (CXR), Scheduled on: Aug-13-2012 Ordered
Feb-18-2013 Future Order: Radiology Order Chest x-ray, two views (71020), Body Site: Lower Respiratory Tract Strcture, Collected on: Aug-06-2012 Ordered
Feb-18-2013 Future Order: Lab Order HGB (NG005041), Scheduled on: Aug-13-2012 Ordered
# Plan of Care Activity Act # Plan of Care Activity Act # Plan of Care Activity Encounter # Plan of Care Activity Encounter # Instructions # Plan of Care Activity Act # Plan of Care Activity Act # Plan of Care Activity Act # Plan of Care Activity Act 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component15
] .
_:component15 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "HistoryOfPresentIllness" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "10164-2" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "HISTORY OF PRESENT ILLNESS" ; dt:CD.codeSystemName "LOINC"
    ]

History Of Present Illness

Mild Fever, 2 days

Chills, 2 days

Cough productive of greenish sputum, 2 days

[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component16
] .
_:component16 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "FunctionalStatus" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "47420-5" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "Functional Status" ; dt:CD.codeSystemName "LOINC"
    ]

Functional Status

Functional / Cognitive Date Status
Cognitive Aug-06-2012 No impairment
Functional Aug-06-2012 Active 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component17
] .
_:component17 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "CcdaMedicationsAdministered" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "29549-3" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "MEDICATION ADMINISTERED" ; dt:CD.codeSystemName "LOINC"
    ]

Medications Administered

Medication Instructions Dosage Effective Dates (start - stop) Status Comments
albuterol sulfate HFA 90 mcg/actuation Aerosol Inhaler inhale 2 puffs once as needed Aug-06-2012 - Aug-06-2012 No Longer Active Administered in office
# Medication Activity 
[ a rim:ActRelationship ;
    rim:ActRelationship.typeCode [ dt:CD.code "COMP" ; dt:CD.codeSystem "???" ] ;
    rim:ActRelationship.source _:ClinicalDoc ;
    rim:ActRelationship.target _:component18
] .
_:component18 a rim:Act ;
    rim:Act.id [ a dt:II ; dt:II.root "2.201" ; dt:II.extension "Instructions" ;  ];
    rim:Act.classCode [ dt:CD.code "ACT" ; dt:CD.codeSystem "2.16.840.1.113883.5.6" ] ;
    rim:Act.moodCode [ dt:CD.code "EVN" ; dt:CD.codeSystem "2.16.840.1.113883.5.1001" ] ;
    rim:Act.code [
        dt:CD.code "69730-0" ; dt:CD.codeSystem "2.16.840.1.113883.6.1" ;
        dt:CD.displayName "INSTRUCTIONS" ; dt:CD.codeSystemName "LOINC"
    ]

Instructions

Date Instruction Additional Information
Feb-12-2013 Patient may continue to experience low grade fever and chills. Related to Community acquired pneumonia
Feb-12-2013 Return to clinic or call 911 if you experience chest pain, shortness of breath, high fevers, or intractable vomiting/diarrhea Related to Community acquired pneumonia
# Instructions # Instructions